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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