Saint Marys Home Infusion Program

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

5301007544 Issued in MI

Legal business name

SAINT MARYS HOME INFUSION PROGRAM

Doing business as

Saint Mary's Home Infusion Prog
Trinity Health Infusion Pharmacy - Cathedral Square

Practice address

360 Division Ave S
Ste #1D
Grand Rapids, MI 49503-4501

Phone

(616) 685-1111

Fax

(616) 685-1122

NPI assigned

Jun 13, 2006

Last updated

Mar 26, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Paul Gusho

Title

Regional Cfo and Treasurer

Phone

(231) 672-3886

Specialties & licenses 8

Addresses

Other identifiers 2

Other names 2

• SAINT MARY'S HOME INFUSION PROG Doing business as
• Trinity Health Infusion Pharmacy - Cathedral Square Doing business as

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

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

Medicare medical equipment & supply locations

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Saint Mary's Health Services

  • Anesthesiology Physician
  • Grand Rapids, MI
  • NPI 1124063078

  Member Of

  NPD member
• Trinity Health - Michigan

  dba Trinity Health Pharmacy - Reichert Center

  • Community/Retail Pharmacy
  • Ypsilanti, MI
  • NPI 1588736375

  Member Of

  NPD member

Locations

Practitioners 5

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.

• Alan Michael Goldman, RPH

  • Pharmacist
  • Grand Rapids, MI
  • NPI 1063409340
  NPD
• Hyung T Kim, M.D.

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1417382821
  NPD
• Nickolas John Kipreos, RPH

  • Pharmacist
  • Lapeer, MI
  • NPI 1275250946
  NPD
• Terry K Kirkpatrick, MS, RPH

  • Pharmacist
  • Grand Rapids, MI
  • NPI 1821070087
  NPD
• Michael Patrick McCormick, PHARM.D.

  • Pharmacist
  • Muskegon, MI
  • NPI 1932560026
  NPD

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742947200000",
    "number": "1841233574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 DIVISION AVE SOUTH",
            "address_2": "STE 1D",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-685-1111",
            "fax_number": "616-685-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 DIVISION AVE S",
            "address_2": "STE #1D",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034501",
            "telephone_number": "616-685-1111",
            "fax_number": "616-685-1122"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3925 32nd Ave",
            "address_purpose": "LOCATION",
            "city": "Hudsonville",
            "state": "MI",
            "postal_code": "494268465",
            "country_code": "US",
            "telephone_number": "616-685-1111",
            "fax_number": "616-685-1122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SAINT MARYS HOME INFUSION PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-07",
        "status": "A",
        "authorized_official_last_name": "GUSHO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "REGIONAL CFO AND TREASURER",
        "authorized_official_telephone_number": "231-672-3886"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MI",
            "license": "5301007544",
            "primary": true
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4440561",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2046108",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SAINT MARY'S HOME INFUSION PROG",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Trinity Health Infusion Pharmacy - Cathedral Square",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Saint Mary's Health Services (Mercy Health Saint Mary's)
• Saint Mary's Hospital
• Saint Mary's Hospital
• Saint Marys Family Pharmacy (Mercy Health Pharmacy-Cathedral Square)
• Saint Marys Family Pharmacy-Wege Center (Mercy Health Pharmacy - Wege Center)
• Keerthi Kiran Sajja, DO
• Bushra Sajjad, M.D.
• Sarah Sak-Smith
• Valerie Sakala
• Ali Saker, M.D.

• Community/Retail Pharmacy in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Community/Retail Pharmacy in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.