Provider Demographics
NPI:1851525844
Name:HOLLAND COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:HOLLAND COMMUNITY HOSPITAL
Other - Org Name:HOLLAND HOSPITAL PEDIATRICS & INTERNAL MEDICINE
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 1:3235 N WELLNESS DR STE 120A
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-8035
Mailing Address - Country:US
Mailing Address - Phone:616-399-0902
Mailing Address - Fax:616-399-0513
Practice Address - Street 1:3235 N WELLNESS DR STE 120A
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-8035
Practice Address - Country:US
Practice Address - Phone:616-399-0902
Practice Address - Fax:616-399-0513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082035207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty