Provider Demographics
NPI:1457339228
Name:TRI-UNITY INFUSION SERVICES, LLC
Entity Type:Organization
Organization Name:TRI-UNITY INFUSION SERVICES, LLC
Other - Org Name:TRI-UNITY PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-214-4446
Mailing Address - Street 1:2061 W CONCORD PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-6197
Mailing Address - Country:US
Mailing Address - Phone:800-996-0976
Mailing Address - Fax:800-883-6613
Practice Address - Street 1:447 S WHITTAKER ST
Practice Address - Street 2:
Practice Address - City:NEW BUFFALO
Practice Address - State:MI
Practice Address - Zip Code:49117
Practice Address - Country:US
Practice Address - Phone:844-214-4446
Practice Address - Fax:800-886-1521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X, 332B00000X, 3336C0004X, 3336H0001X, 3336I0012X, 3336S0011X
MI5301008165251F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251E00000XAgenciesHome Health
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL054.021028OtherPHARMACY LICENSE
MN2469-43OtherPHARMACY LICENSE
IN64002718AOtherPHARMACY LICENSE
MI5301008165OtherPHARMACY LICENSE
MI4750671Medicaid
AZY007882OtherPHARMACY LICENSE
MI1457339228OtherBLUECROSS BLUESHIELD OF MICHIGAN
MN266602OtherPHARMACY LICENSE
MI2367363OtherMEDIMPACT
MI2367363Medicaid