Healthcare Provider Details

I. General information

NPI: 1629420849
Provider Name (Legal Business Name): LINDSEY KRAEER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2016
Last Update Date: 07/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 COLLIERS WAY
WEIRTON WV
26062
US

IV. Provider business mailing address

651 COLLIERS WAY
WEIRTON WV
26062-5053
US

V. Phone/Fax

Practice location:
  • Phone: 304-723-6331
  • Fax: 304-723-1131
Mailing address:
  • Phone: 304-723-6331
  • Fax: 304-723-1131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP0008166
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP448236
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH.03233465
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: