# TRINITY HEALTH - MICHIGAN

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** TRINITY HEALTH - MICHIGAN
- **Other names:** Trinity Health Pharmacy Long Term Care-Cathedral Square, Mercy Health pharmacy - Long Term Care
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1295761914
- **Legal business name:** TRINITY HEALTH - MICHIGAN
- **Authorized official:** ROBERT CASALOU (PRESIDENT/CEO)
- **Authorized official phone:** (734) 712-3792

## Contact information

- **Practice address:** 360 DIVISION AVE S, STE 1C, GRAND RAPIDS, MI 49503-4501
- **Practice address phone:** (616) 685-1100
- **Practice address fax:** (616) 685-1196
- **Mailing address:** 360 DIVISION AVE S, STE 1C, GRAND RAPIDS, MI 49503-4501
- **Mailing address phone:** (616) 685-1100
- **Mailing address fax:** (616) 685-1115

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 5301005760 | MI | Yes |

## Other

- **Enumeration date:** 06/24/2006
- **Last updated:** 05/24/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2042216 | PK | — |
| 05 | — | 4825128 | — | MI |