Provider Demographics
NPI:1841607843
Name:TRINITY HEALTH-MICHIGAN
Entity type:Organization
Organization Name:TRINITY HEALTH-MICHIGAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-712-7796
Mailing Address - Street 1:36475 FIVE MILE RD
Mailing Address - Street 2:ROOM 21520
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-1971
Mailing Address - Country:US
Mailing Address - Phone:734-655-2325
Mailing Address - Fax:734-655-8595
Practice Address - Street 1:36475 FIVE MILE RD
Practice Address - Street 2:ROOM 21520
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1971
Practice Address - Country:US
Practice Address - Phone:734-655-2325
Practice Address - Fax:734-655-8595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010105113336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy