| Organization Name: | PENNOCK HOSPITAL BOARD OF TRUSTEES |
| NPI Number: | 1962889584 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CONNIE S DOWNS (VICE PRESIDENT OF CORPORATE DEVELOP) |
| Mailing Address: | 4294 Laurel Dr Lake Odessa |
| State: | MI US |
| Postal Code: | 488498430 |
| Phone Number: | 6163747660 |
| Fax Number: | 6163740270 |
| NPI Enumeration Date: | 05/04/2015 |
| NPI Last Update Date: | 11/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |