Healthcare Provider Details

I. General information

NPI: 1366438038
Provider Name (Legal Business Name): NORTH OTTAWA COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 08/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1071 S BEACON BLVD
GRAND HAVEN MI
49417-2607
US

IV. Provider business mailing address

1071 S BEACON BLVD
GRAND HAVEN MI
49417-2607
US

V. Phone/Fax

Practice location:
  • Phone: 616-846-0360
  • Fax:
Mailing address:
  • Phone: 616-846-0360
  • 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 Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. NORA BOITEN
Title or Position: COO
Credential: RN
Phone: 616-846-2015