Trinity Health Pharmacy - Cathedral Square

LBN: Saint Marys Family Pharmacy
Trinity Health Pharmacy - Cathedral Square is an health care organization with primary practice located at 360 Division Ave S Ste 1A, Grand Rapids MI 49503-4501. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Saint Marys Family Pharmacy can be contacted via phone (616) 685-1147, or through Casalou, Robert via phone (734) 712-3792.

Contact Information

Primary practice address
360 Division Ave S Ste 1A Grand Rapids MI 49503-4501
Fax: (616) 685-1145
Website:
Authorized official contact:
Name: Casalou, Robert

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 5301004226 Michigan

Profile Details

NPI number 1679519581
LBN Legal business name Saint Marys Family Pharmacy
DBA Doing business as Trinity Health Pharmacy - Cathedral Square
Authorized official Casalou, Robert
Entity Organization
Organization subpart 1 No
Enumeration date Jun 20th, 2006
Last updated Sep 26th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679519581 NPPES
Other 2045998 PK
MEDICAID 1679519581 PK
MEDICAID 4825146 PK

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