Healthcare Provider Details

I. General information

NPI: 1871997247
Provider Name (Legal Business Name): HOPE NETWORK WEST MICHIGAN TRANSPORTATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2014
Last Update Date: 10/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3075 ORCHARD VISTA DR SE
GRAND RAPIDS MI
49546-7069
US

IV. Provider business mailing address

PO BOX 890
GRAND RAPIDS MI
49518-0890
US

V. Phone/Fax

Practice location:
  • Phone: 616-301-8000
  • Fax:
Mailing address:
  • Phone: 616-301-8000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347B00000X
TaxonomyBus
License Number
License Number StateMI

VIII. Authorized Official

Name: PHILIP W WEAVER
Title or Position: PRESIDENT
Credential: CEO
Phone: 616-301-8000