Corewell Health Pennock Hospital Family Medicine - Lake Odessa

LBN: Pennock Hospital
Corewell Health Pennock Hospital Family Medicine - Lake Odessa is an health care organization with primary practice located at 4294 Laurel Dr , Lake Odessa MI 48849-8430. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rural Health, which is considered as the primary health care specialty. Pennock Hospital can be contacted via phone (616) 374-7660, or through Sella, John via phone (616) 802-0206.

Contact Information

Primary practice address
4294 Laurel Dr Lake Odessa MI 48849-8430
Phone: (616) 374-7660
Fax: (616) 374-0270
Website:
Map and Directions
Authorized official contact:
Name: Sella, John
Phone: (616) 802-0206

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rural Health 261QR1300X

Profile Details

NPI number 1962889584
LBN Legal business name Pennock Hospital
DBA Doing business as Corewell Health Pennock Hospital Family Medicine - Lake Odessa
Authorized official Sella, John
Entity Organization
Organization subpart 1 Yes
Enumeration date May 4th, 2015
Last updated Aug 23rd, 2023 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962889584 NPPES
Michigan Other 238675 MEDICARE PTAN

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