Organization
FAMILY PHARMACY-SW CAMPUS
Active
Other names
Trinity Health Pharmacy - Byron Center, MERCY HEALTH PHARMACY-SOUTHWEST
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT CASALOU (PRESIDENT/CEO)
(734) 712-3792
Entity
Organization
Contact information
Practice address
2373 64TH ST SW, STE 1100, BYRON CENTER, MI 49315-7974
(616) 685-3950
(616) 249-0850
Mailing address
2373 64TH ST SW, STE 1100, BYRON CENTER, MI 49315-7974
(616) 685-3950
(616) 249-0850
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301008486
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235226424
—
MI
01
—
2042398
PK
—
05
—
4110913
—
MI
Enumeration date
10/07/2006
Last updated
09/26/2022
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