Provider Demographics
NPI:1679778229
Name:TRINITY HEALTH-MICHIGAN
Entity Type:Organization
Organization Name:TRINITY HEALTH-MICHIGAN
Other - Org Name:SAINT JOSEPH MERCY HOSPITAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SDL-PHARMACY OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-712-5194
Mailing Address - Street 1:5301 MCAULEY DR
Mailing Address - Street 2:ROOM 1267
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1051
Mailing Address - Country:US
Mailing Address - Phone:734-712-3431
Mailing Address - Fax:734-712-8619
Practice Address - Street 1:5301 MCAULEY DR
Practice Address - Street 2:ROOM 1267
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1051
Practice Address - Country:US
Practice Address - Phone:734-712-3431
Practice Address - Fax:734-712-8619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-15
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301001628282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital