Provider Demographics
NPI:1235731266
Name:SAV-MAX MERRIMAN PHARMACY LLC
Entity Type:Organization
Organization Name:SAV-MAX MERRIMAN PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABIR
Authorized Official - Middle Name:
Authorized Official - Last Name:BARAKAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-406-6209
Mailing Address - Street 1:2255 FORT ST STE B
Mailing Address - Street 2:
Mailing Address - City:LINCOLN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48146-2777
Mailing Address - Country:US
Mailing Address - Phone:313-406-6209
Mailing Address - Fax:313-406-6205
Practice Address - Street 1:2255 FORT ST STE B
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:MI
Practice Address - Zip Code:48146-2777
Practice Address - Country:US
Practice Address - Phone:313-406-6209
Practice Address - Fax:313-406-6947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-13
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1235731266Medicaid