Healthcare Provider Details

I. General information

NPI: 1619726189
Provider Name (Legal Business Name): SASHA T KRAMER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2024
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16269 US HIGHWAY 160
FORSYTH MO
65653-7122
US

IV. Provider business mailing address

18565 BUSINESS 13
BRANSON WEST MO
65737-9659
US

V. Phone/Fax

Practice location:
  • Phone: 417-546-5151
  • Fax: 417-546-4591
Mailing address:
  • Phone: 417-272-8064
  • Fax: 417-272-0073

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2009025380
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: