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General NPI Number Information
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NPI Number | 1770642589
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Entity Type | Organization
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Legal Business Name | JASON KRAMER
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 06/28/2016
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Provider Practice Location Address
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Address Line | 2 FOREST HILL RD
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City | MIFFLINBURG
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State | PA
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Zip | 17844-1323
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Country | US
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Telephone | 570-966-5001
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Fax | 570-966-7046
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Provider Business Mailing Address
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Address Line | 2 FOREST HILL RD
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City | MIFFLINBURG
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State | PA
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Zip | 17844-1323
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Country | US
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Telephone | 570-966-5001
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Fax | 570-966-7046
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Authorized Official
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Title or Position | PHARMACY MANAGER AND OWNER
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Name | JASON KRAMER
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Credential | RPH
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Telephone | 570-966-5001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PP481330
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License Number State | PA
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