Provider Demographics
NPI:1861682841
Name:SAINT JOSEPH MERCY HOSPITAL LIVINGSTON
Entity Type:Organization
Organization Name:SAINT JOSEPH MERCY HOSPITAL LIVINGSTON
Other - Org Name:TRINITY HEALTH OF MICHIGAN
Other - Org Type:Other Name
Authorized Official - Title/Position:SDL-LIVINGSTON PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:
Authorized Official - Last Name:VANDER LINDE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:517-545-6200
Mailing Address - Street 1:620 BYRON RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-1002
Mailing Address - Country:US
Mailing Address - Phone:517-545-6200
Mailing Address - Fax:517-545-6727
Practice Address - Street 1:620 BYRON RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-1002
Practice Address - Country:US
Practice Address - Phone:517-545-6200
Practice Address - Fax:517-545-6727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301002596282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital