Organization
TRINITY HEALTH - MICHIGAN
Active
Parent organization
TRINITY HEALTH - MICHIGAN
Other names
STJOSEPH MERCY PROFESSIONAL PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
TRINITY HEALTH - MICHIGAN
Authorized official
MR. PHILLIP J WEIN PHARMACIST (MANAGER, PHARMACY SERVICES)
(248) 858-3053
Entity
Organization
Contact information
Practice address
44405 WOODWARD AVE, PONTIAC, MI 48341-5023
(248) 858-6725
(248) 858-6726
Mailing address
44405 WOODWARD AVE, PONTIAC, MI 48341-5023
(248) 858-3053
(248) 858-3010
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301007049
MI
3336S0011X
Specialty Pharmacy
5301007049
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2360345
NABP/NCPDP #
MI
05
—
4127581
—
MI
01
—
5301007049
MICHIGAN LICENSE #
MI
Enumeration date
10/05/2006
Last updated
03/07/2023
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