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SAINT MARYS HOME INFUSION PROGRAM NPI 1841233574


NPI Information

NPI: 1841233574
Provider Name: SAINT MARYS HOME INFUSION PROGRAM

Doing Business As: SAINT MARY'S HOME INFUSION PROG

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
360 DIVISION AVE S
STE #1D
GRAND RAPIDS, MI
ZIP 49503
Phone: (616) 685-1111
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SAINT MARYS HOME INFUSION PROGRAM is a community/retail pharmacy pharmacy in Grand Rapids, MI. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. SAINT MARYS HOME INFUSION PROGRAM NPI is 1841233574. The provider is registered as an organization entity type.
The provider Is Doing Business As Saint Mary's Home Infusion Prog.

The provider's business location address is:

360 DIVISION AVE S
STE #1D
GRAND RAPIDS, MI
ZIP 49503-501
Phone: (616) 685-1111
Fax: (616) 685-1122

The provider's authorized official is Kyle William Baker .
The authorized official title is Pharmacy Supervisor and has the following contact phone number (616) 685-1129.

The enumeration date for this NPI number is 6/13/2006 and was last updated on 5/18/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251E00000XHome HealthNo
2251F00000XHome InfusionNo
3261QI0500XClinic/CenterInfusion TherapyNo
4332B00000XDurable Medical Equipment & Medical SuppliesNo
5333600000XPharmacyNo
63336H0001XPharmacyHome Infusion Therapy PharmacyNo
73336S0011XPharmacySpecialty PharmacyNo
83336C0003XPharmacyCommunity/Retail Pharmacy5301007544MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
14440561MEDICAIDMICHIGAN
22046108OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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