| Pennock Hospital | |
| 
					12851 W M 179 Hwy Wayland MI 49348-9318  | |
| (877) 377-7322 | |
| Not Available | 
| Full Name | Pennock Hospital | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 12851 W M 179 Hwy, Wayland, Michigan | 
| Authorized Official Name and Position | John Sella (CONTROLLER) | 
| Authorized Official Contact | 6168020206 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Pennock Hospital 100 Michigan St Ne Mc 845 Grand Rapids MI 49503-2560 Ph: () -  | Pennock Hospital 12851 W M 179 Hwy Wayland MI 49348-9318 Ph: (877) 377-7322  | 
| NPI Number | 1801250907 | 
|---|---|
| Provider Enumeration Date | 04/05/2016 | 
| Last Update Date | 08/23/2023 | 
| Medicare PECOS PAC ID | 4587551015 | 
|---|---|
| Medicare Enrollment ID | O20180920002843 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1801250907 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary | 
Family Physicians, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1850 Parker Dr, Wayland, MI 49348 Phone: 616-406-7799  |