MEDICARE: ANDREW MARVIN SCHRAMM PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	2012029738	MO

General Provider Information

NPI Number	:	1356692719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW MARVIN SCHRAMM PHARM.D.

Provider Business Mailing Address
First Line	:	4413 JEFFERSON STREET APARTMENT 103
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111
Country	:	US
Telephone Number	:	816-637-5555
Fax Number	:	816-637-5701

Provider Business Practice Location Address
First Line	:	4413 JEFFERSON ST APT 103
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3445
Country	:	US
Telephone Number	:	816-637-5555
Fax Number	:	816-637-5701

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2012
Last Update Date	:	09/26/2012

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