Provider Demographics
NPI:1952507444
Name:HOLLAND COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:HOLLAND COMMUNITY HOSPITAL
Other - Org Name:WESTERN MICHIGAN UROLOGICAL ASSOC.
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 1:577 MICHIGAN AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-4911
Mailing Address - Country:US
Mailing Address - Phone:616-392-1816
Mailing Address - Fax:616-392-1292
Practice Address - Street 1:577 MICHIGAN AVE STE 201
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49423-4911
Practice Address - Country:US
Practice Address - Phone:616-392-1816
Practice Address - Fax:616-392-1292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-22
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty