Healthcare Provider Details
I. General information
NPI: 1700549169
Provider Name (Legal Business Name): HOLLAND COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/21/2021
Last Update Date: 05/23/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6490 BLUE STAR HWY
SAUGATUCK MI
49453-9725
US
IV. Provider business mailing address
6490 BLUE STAR HWY
SAUGATUCK MI
49453-9725
US
V. Phone/Fax
- Phone: 269-857-3208
- Fax: 269-857-3222
- Phone: 269-857-3208
- Fax: 269-857-3222
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALEXANDER
ROEHLING
Title or Position: CFO
Credential:
Phone: 616-394-3456