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DSH230072T HOLLAND HOSPITAL (Active)
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Main Details
Name
HOLLAND HOSPITAL
Subdivision Name
HH PET CT Services
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH230072T
Medicare Provider Number
230072
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
7/6/2015
Participating Start Date
10/1/2015
Participating Approval Date
7/15/2015
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
8300 Westpark Way
Zeeland, MI 49464
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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May 2025
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