Organization Active NPI

Trinity Health - Michigan

Doing business as Trinity Health Pharmacy - Schoolcraft Campus

  • Community/Retail Pharmacy
  • Livonia, MI
National Provider Identifier
1306412184
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
TRINITY HEALTH - MICHIGAN
Doing business as
Trinity Health Pharmacy - Schoolcraft Campus
Practice address
19000 St. Joe's Parkway
Suite 120
Livonia, MI 48152
Phone
(734) 743-4646
Fax
(734) 743-4373
NPI assigned
Jun 2, 2021
Last updated
Sep 13, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ariana Grace Raymond
Title
Manager, Provider Enrollment
Phone
(734) 343-1466

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

19000 St. Joe's Parkway
Suite 120
Livonia, MI 48152

Mailing address

5333 McAuley Dr Ste R6106
Ypsilanti, MI 48197-1014
Phone (517) 420-4864

Other names 1

  • Trinity Health Pharmacy - Schoolcraft Campus Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200604002163 MI Part B Supplier - Mass Immunization (Roster Biller Only) 7618878943 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Grand Rapids, MI; Howell, MI; Hudsonville, MI; Livonia, MI; Pontiac, MI; Rockford, MI; Ypsilanti, MI

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2218590Trinity Health Medical Center - Schoolcraft Campus19000 St Joes Parkway Suite 110, Livonia, MI 48152AccreditationNov 23, 2027

National Provider Directory

National Provider Directory

Locations

5333 McAuley Dr
Ste R6106
Ypsilanti, MI 48197

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663027200000",
    "number": "1306412184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5333 MCAULEY DR STE R6106",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971014",
            "telephone_number": "517-420-4864",
            "fax_number": "734-712-1274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19000 ST. JOE'S PARKWAY",
            "address_2": "SUITE 120",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "48152",
            "telephone_number": "734-743-4646",
            "fax_number": "734-743-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY HEALTH - MICHIGAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-02",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A",
        "authorized_official_last_name": "RAYMOND",
        "authorized_official_first_name": "ARIANA",
        "authorized_official_middle_name": "GRACE",
        "authorized_official_title_or_position": "MANAGER, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "734-343-1466"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trinity Health Pharmacy - Schoolcraft Campus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.