Organization
PENNOCK HOSPITAL
Active
Other names
Pennock Homecare Services
Organization subpart
No
Provider details
NPI number
Authorized official
SHERYL L LEWIS-BLAKE (PRESIDENT)
(269) 948-3123
Entity
Organization
Contact information
Practice address
1009 W GREEN ST, HASTINGS, MI 49058-1710
(269) 945-1212
(269) 948-3117
Mailing address
1009 W GREEN ST, HASTINGS, MI 49058-1710
(269) 945-1212
(269) 948-3117
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3332247
—
MI
01
—
OE155
BCBS PROVIDER NUMBER
MI
Enumeration date
06/11/2006
Last updated
04/27/2016
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