Provider Demographics
NPI:1508095530
Name:HOLLAND COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:HOLLAND COMMUNITY HOSPITAL
Other - Org Name:HOLLAND HOSPITAL NEUROLOGY
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:ROEHLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-394-3456
Mailing Address - Street 1:844 WASHINGTON AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-7186
Mailing Address - Country:US
Mailing Address - Phone:616-396-7366
Mailing Address - Fax:616-392-2889
Practice Address - Street 1:844 WASHINGTON AVE STE 1200
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-7186
Practice Address - Country:US
Practice Address - Phone:616-396-7366
Practice Address - Fax:616-392-2889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-12
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010791532084N0400X
2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty