Organization
TRINITY HEALTH - MICHIGAN
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
Legal business name
TRINITY HEALTH - MICHIGAN
Authorized official
ROBERT CASALOU (PRESIDENT/CEO)
(734) 712-3792
Entity
Organization
Contact information
Practice address
360 DIVISION AVE S, STE 1C, GRAND RAPIDS, MI 49503-4501
(616) 685-1100
(616) 685-1196
Mailing address
360 DIVISION AVE S, STE 1C, GRAND RAPIDS, MI 49503-4501
(616) 685-1100
(616) 685-1115
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
5301005760
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2042216
PK
—
05
—
4825128
—
MI
Enumeration date
06/24/2006
Last updated
05/24/2023
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