Organization
PENNOCK HOSPITAL
Active
Organization
PENNOCK HOSPITAL
Active
Parent organization
PENNOCK HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENNOCK HOSPITAL
Authorized official
DEIDRE WELLER (CONTROLLER)
(269) 945-1212
Entity
Organization
Contact information
Practice address
840 COOK RD, HASTINGS, MI 49058-9616
(269) 945-9520
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
03/07/2014
Last updated
04/22/2016
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