Organization
SAINT MARYS HOME INFUSION PROGRAM
Active
Other names
SAINT MARY'S HOME INFUSION PROG, Trinity Health Infusion Pharmacy - Cathedral Square
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL PAUL GUSHO (REGIONAL CFO AND TREASURER)
(231) 672-3886
Entity
Organization
Contact information
Practice address
360 DIVISION AVE S, STE #1D, GRAND RAPIDS, MI 49503-4501
(616) 685-1111
(616) 685-1122
Mailing address
360 DIVISION AVE SOUTH, STE 1D, GRAND RAPIDS, MI 49503
(616) 685-1111
(616) 685-1122
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301007544
MI
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2046108
PK
—
05
—
4440561
—
MI
Enumeration date
06/13/2006
Last updated
03/26/2025
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