Organization
SAINT MARYS FAMILY PHARMACY
Active
Other names
Trinity Health Pharmacy - Cathedral Square, MERCY HEALTH PHARMACY-CATHEDRAL SQUARE
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT CASALOU (PRESIDENT/CEO)
(734) 712-3792
Entity
Organization
Contact information
Practice address
360 DIVISION AVE S, STE 1A, GRAND RAPIDS, MI 49503-4501
(616) 685-1147
(616) 685-1145
Mailing address
360 DIVISION AVE S, STE 1A, GRAND RAPIDS, MI 49503-4501
(616) 685-1147
(616) 685-1145
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301004226
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679519581
—
MI
01
—
2045998
PK
—
05
—
4825146
—
MI
Enumeration date
06/20/2006
Last updated
09/26/2022
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