Healthcare Provider Details

I. General information

NPI: 1174800437
Provider Name (Legal Business Name): HOLLAND COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2011
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 WASHINGTON AVE
HOLLAND MI
49423-7724
US

IV. Provider business mailing address

904 WASHINGTON AVE STE 210
HOLLAND MI
49423-7724
US

V. Phone/Fax

Practice location:
  • Phone: 616-392-8035
  • Fax:
Mailing address:
  • Phone: 616-392-8035
  • Fax: 616-394-7404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDER ROEHLING
Title or Position: CFO
Credential:
Phone: 616-394-3456