Healthcare Provider Details

I. General information

NPI: 1396807228
Provider Name (Legal Business Name): JAMES E KRAMER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3164 LEWIS AVE
IDA MI
48140-9703
US

IV. Provider business mailing address

1136 WENTWORTH ST
HOLLAND OH
43528-8784
US

V. Phone/Fax

Practice location:
  • Phone: 734-269-9245
  • Fax: 734-269-2394
Mailing address:
  • Phone: 419-868-5208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302024282
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: