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DSH230072F HOLLAND HOSPITAL (Active)
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Main Details
Name
HOLLAND HOSPITAL
Subdivision Name
Northside Rehab Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230072F
Medicare Provider Number
230072
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
11/29/2011
Participating Start Date
1/1/2012
Participating Approval Date
12/19/2011
Last Recertification Date
9/4/2024
Contacts
Authorizing Official
Holland Hospital
Mark Pawlak, President
(616) 392-5141
Primary Contact
Holland Hospital
Zachary C Tamminga, Director Finance Administration
(616) 395-4472
Addresses
Street Address
370 N. 120th Avenue
Holland, MI 49424
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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