Provider Demographics
NPI:1871672618
Name:HOLLAND COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:HOLLAND COMMUNITY HOSPITAL
Other - Org Name:HOLLAND HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:ROEHLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-392-5141
Mailing Address - Street 1:602 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-4918
Mailing Address - Country:US
Mailing Address - Phone:616-392-5141
Mailing Address - Fax:616-394-3729
Practice Address - Street 1:602 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-4918
Practice Address - Country:US
Practice Address - Phone:616-392-5141
Practice Address - Fax:616-394-3729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282N00000XHospitalsGeneral Acute Care Hospital
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI00130OtherBCBSM
MI30 1898523Medicaid
MIP00130OtherBCN
MI650OtherPRIORITY HEALTH
MI40 1898541Medicaid
MI0N83180020Medicare PIN
MI230072Medicare ID - Type Unspecified
MI00130OtherBCBSM
MI0N83180001Medicare PIN
MI40 1898541Medicaid
MI0N83180006Medicare PIN
MI30 1898523Medicaid