Organization
PENNOCK HOSPITAL
Active
Other names
Corewell Health Pennock Hospital, Spectrum Health Pennock
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW E COX (CFO)
(616) 391-1663
Entity
Organization
Contact information
Practice address
1009 W GREEN ST, HASTINGS, MI 49058-1710
(269) 945-3451
Mailing address
100 MICHIGAN ST NE, GRAND RAPIDS, MI 49503-2560
(616) 643-9143
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
1060000022
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00101
BLUE CROSS BLUE SHIELD
—
Enumeration date
07/06/2018
Last updated
08/15/2023
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