Healthcare Provider Details

I. General information

NPI: 1437259462
Provider Name (Legal Business Name): KRAMERICA HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 06/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 CENTRAL AVE
DODGE CITY KS
67801-6411
US

IV. Provider business mailing address

2020 CENTRAL AVE
DODGE CITY KS
67801-6411
US

V. Phone/Fax

Practice location:
  • Phone: 620-227-8506
  • Fax: 620-225-3657
Mailing address:
  • Phone: 620-227-8506
  • Fax: 620-225-3657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2-10217
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PAUL KRAMER
Title or Position: PIC AND MANAGER
Credential: RPH
Phone: 670-227-8506