Provider Demographics
NPI:1003435777
Name:SULKA, SARAH ALYSE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ALYSE
Last Name:SULKA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 ELLERY AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-1815
Mailing Address - Country:US
Mailing Address - Phone:269-757-2892
Mailing Address - Fax:
Practice Address - Street 1:5301 EAST HURON RIVER DRIVE
Practice Address - Street 2:ROOM #110
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48106
Practice Address - Country:US
Practice Address - Phone:734-712-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-13
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302040928183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist