Healthcare Provider Details

I. General information

NPI: 1114227329
Provider Name (Legal Business Name): NORTH OTTAWA COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2010
Last Update Date: 10/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 SHELDON AVE SUITE 104
GRAND HAVEN MI
49417-2402
US

IV. Provider business mailing address

1445 SHELDON AVE SUITE 104
GRAND HAVEN MI
49417-2402
US

V. Phone/Fax

Practice location:
  • Phone: 616-847-5504
  • Fax:
Mailing address:
  • Phone: 616-847-5504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: DONALD J LONGPRE
Title or Position: VP FINANCE
Credential: CFO
Phone: 616-842-3600