| Pennock Hospital | |
| 
					490 Edward St Middleville MI 49333-9131  | |
| (269) 795-4434 | |
| (269) 795-4271 | 
| Full Name | Pennock Hospital | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 490 Edward St, Middleville, 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 490 Edward St Middleville MI 49333-9131 Ph: (269) 795-4434  | 
| NPI Number | 1013453760 | 
|---|---|
| Provider Enumeration Date | 01/18/2017 | 
| Last Update Date | 08/23/2023 | 
| Medicare PECOS PAC ID | 4587551015 | 
|---|---|
| Medicare Enrollment ID | O20180920002249 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1013453760 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary | 
Middleville Doctors, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4695 N M 37 Hwy, Middleville, MI 49333 Phone: 269-795-3315 Fax: 269-795-3542  | |
Pennock Hospital Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 490 Edward St, Middleville, MI 49333 Phone: 269-795-4434  |