PENNOCK HOSPITAL BOARD OF TRUSTEES (NPI# 1053635359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053635359 |
| Entity Type | Organization |
| Organization Name | PENNOCK HOSPITAL BOARD OF TRUSTEES |
| Other Organization Name | PENNOCK HOSPITAL LAKE ODESSA SAT LAB |
| Practice Address |
4294 Laurel Dr Lake Odessa MI 48849-8430 |
| Mailing Address |
1009 W Green St Hastings MI 49058-1710 |
| Practice Telephone | 2699451212 |
| Practice Fax Number | 6166741698 |
| Mailing Telephone | 2699451212 |
| Mailing Fax Number | 2699483117 |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2013-03-11 |
| Authorized Official Name | MR. THOMAS SALISBURY (FINANCE DIRECTOR) |
| Authorized Official Telephone | 2699451212 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | MI | Hospitals |
| Other Name | Type Code |
|---|---|
| Pennock Hospital Lake Odessa Sat Lab | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780046227 | Pennock Hospital Board of Trustees | Obstetrics & Gynecology | 11275 Sprague Rd, Delton, MI 49046-8493 | 2016-03-23 |
| 1124488812 | Pennock Hospital Board of Trustees | Surgery | 1005 W Green St, Hastings, MI 49058-1712 | 2016-02-24 |
| 1508225632 | Pennock Hospital Board of Trustees | Family Medicine | 1108 W State St, Hastings, MI 49058-9711 | 2016-02-17 |
| 1104291202 | Pennock Hospital Board of Trustees | Internal Medicine | 2776 S State Rd, Ionia, MI 48846-8472 | 2015-12-01 |
| 1841488178 | Pennock Hospital Board of Trustees | Emergency Medicine | 1009 W Green Street, Hastings, MI 49058-1710 | 2007-10-11 |
| Street Address |
4294 LAUREL DR |
| City | LAKE ODESSA |
| State | MI |
| Zip Code | 48849-8430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578580080 | Total Health Center Hastings Inc | Physical Therapist | 4294 Laurel Dr, Ste 2, Lake Odessa, MI 48849 | 2006-07-17 |
| 1215470265 | Zachary Daniel Jones | Physician Assistant | 4294 Laurel Dr, Lake Odessa, MI 48849-8430 | 2016-11-23 |
| 1023562519 | Michelle Vanburen | Nurse Practitioner | 4294 Laurel Dr, Lake Odessa, MI 48849-8430 | 2016-08-12 |
| 1275999286 | Pennock Hospital | Family Medicine | 4294 Laurel Dr, Lake Odessa, MI 48849-8430 | 2016-01-06 |
| 1962889584 | Pennock Hospital | Clinic/Center | 4294 Laurel Dr, Lake Odessa, MI 48849-8430 | 2015-05-04 |
| 1508269705 | Spectrum Health Primary Care Partners | Internal Medicine | 4294 Laurel Dr, Lake Odessa, MI 48849-8430 | 2014-10-01 |
| 1891105508 | West Michigan Heart | Internal Medicine | 4294 Laurel Dr, Lake Odessa, MI 48849-8430 | 2014-05-02 |
| 1184911836 | Christopher R Shoemaker | Family Medicine | 4294 Laurel Dr, Lake Odessa, MI 48849-8430 | 2011-07-01 |
| 1942509666 | Laurie S Braker Md Plc | Family Medicine | 4294 Laurel Dr, Lake Odessa, MI 48849-8430 | 2011-03-21 |
| 1427216241 | Pine Rest Christian Mental Health Services | Counselor | 4294 Laurel Dr, Lake Odessa, MI 48849-9423 | 2008-05-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851512339 | Christine Margaret Thomas | Pharmacist | 838 Fouth Ave, Lake Odessa, MI 48849 | 2007-05-01 |
| 1275641649 | Advanced Rx LLC | Pharmacy | 838 4th Avenue, Lake Odessa, MI 48849 | 2006-08-27 |
| 1831608108 | Lake Odessa Pharmacy | Pharmacy | 802 4th Ave, Lake Odessa, MI 48849-1002 | 2017-09-29 |
| 1104914001 | William H Walker | Pharmacist | 838 4th Ave, Lake Odessa, MI 48849-1002 | 2006-10-10 |
| 1851340335 | Catherine Hemingway | Dental Hygienist | 924 4th Ave, Lake Odessa, MI 48849-1003 | 2006-05-10 |
| 1639258320 | Aaron Blane Freeman | Dentist | 924 4th Ave, Lake Odessa, MI 48849-1003 | 2006-11-03 |
| 1083133607 | Vicki Davison | Psychologist | 1040 4th Ave, Lake Odessa, MI 48849-1004 | 2017-09-14 |
| 1215024369 | Gerald T Licari Dds PC | Dentist | 1032 4th Ave, Lake Odessa, MI 48849-1004 | 2006-10-09 |
| 1558320846 | Clarence Richard Barnett | Family Medicine | 1020 4th Ave, Lake Odessa, MI 48849-1004 | 2006-03-23 |
| 1851889471 | Lake Odessa Dental, Pllc | Clinic/Center | 1032 4th Ave, Lake Odessa, MI 48849-1004 | 2018-04-30 |
| Find all providers in zip 48849 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740899194 | Ascension Michigan Employer Solutions LLC | General Acute Care Hospital | 5555 Conner St Ste 2818, Detroit, MI 48213-3448 | 2020-07-30 |
| 1295246106 | Henry Ford Health Sytems | General Acute Care Hospital | 18800 Hubbard Dr, Dearborn, MI 48126-4305 | 2017-10-18 |
| 1972043081 | Melissa Kovaleski | General Acute Care Hospital | 1029 Chestnut Ln, South Lyon, MI 48178-1896 | 2017-03-08 |
| 1699125922 | Sarah Finlay | General Acute Care Hospital | 5333 Mcauley Dr Ste 40001, Ypsilanti, MI 48197-1014 | 2016-06-17 |
| 1528412517 | Bess Marie Connors | General Acute Care Hospital | 1506 Pontiac Trl, Ann Arbor, MI 48105-1719 | 2016-04-16 |
| 1093198624 | The Memorial Hospital | General Acute Care Hospital | 826 W King St # 1-117, Owosso, MI 48867-2120 | 2015-07-01 |
| 1326428285 | Ipc Hospitalist Company | General Acute Care Hospital | 1628 Huntwood Park Ct, West Bloomfield, MI 48324-3998 | 2015-06-05 |
| 1689088304 | Florida Hospital | General Acute Care Hospital | 7922 Barrie, Dearborn, MI 48126 | 2014-06-20 |
| 1720491954 | University of Michigan | General Acute Care Hospital | 1515 E. Hospital Drive, Towsley Center, 1218, Spc 5222, Ann Arbor, MI 48109-5222 | 2014-06-05 |
| 1366866956 | Bronson Methodist Hospital | General Acute Care Hospital | 601 John St Ste M-425, Kalamazoo, MI 49007-5354 | 2014-02-18 |
| Find all providers with the same taxonomy | ||||
| City | LAKE ODESSA |
| Zip Code | 48849 |
Please comment or provide details below to improve the information on PENNOCK HOSPITAL BOARD OF TRUSTEES.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.