Provider Demographics
NPI:1275740219
Name:SALAMEN & WORTHING ENTERPRISES LLC
Entity Type:Organization
Organization Name:SALAMEN & WORTHING ENTERPRISES LLC
Other - Org Name:CLARK PROFESSIONAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP/SECRETARY/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-808-9838
Mailing Address - Street 1:3280 WASHTENAW AVE
Mailing Address - Street 2:STE B
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4250
Mailing Address - Country:US
Mailing Address - Phone:734-369-8782
Mailing Address - Fax:734-585-5184
Practice Address - Street 1:3280 WASHTENAW AVE
Practice Address - Street 2:STE B
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4250
Practice Address - Country:US
Practice Address - Phone:734-369-8782
Practice Address - Fax:734-585-5184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010088303336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy