Organization · Type 2 NPI

Pennock Hospital

Rural Health Clinic/Center · Ionia, MI

NPI number 1477940773 Active

Practice location

2776 S State Rd
Ionia, MI 48846-8472

Call (616) 775-7500 Map

Fax (616) 775-7510

Mailing address

100 Michigan St NE, Mc 845
Grand Rapids, MI 49503-2560

Specialties and licenses

Taxonomy	Code	License
Rural Health Clinic/Center Primary	261QR1300X	None listed

Rural Health Clinic/Center: Definition to come...

23 other providers at this address

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NPI record

NPI: 1477940773
Entity type: Organization (Type 2)
Issued: Apr 24, 2015
Last updated: Aug 23, 2023
Status: Active
Subpart: Yes of Pennock Hospital

Other names

<unavail>
Corewell Health Pennock Hospital Multispecialty Center - Ionia · doing business as
Spectrum Health Pennock Family Medicine-Ionia · doing business as

Authorized official

Robert Davis
Director of Operations
(269) 945-1212

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1477940773

Pennock Hospital's National Provider Identifier is 1477940773, issued on Apr 24, 2015. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Ionia, MI. The record was last updated on Aug 23, 2023.