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NPI Code Detail

MEDICARE: JAMIE KRAEMER

MEDICARE: JAMIE KRAEMER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist017797KY

General Provider Information

NPI Number : 1083097232
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE KRAEMER
Provider Business Mailing Address
First Line : 2300 MERRICK RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40207-1255
Country : US
Telephone Number : 502-905-7495
Fax Number :
Provider Business Practice Location Address
First Line : 2300 MERRICK RD
Second Line :
City : LOUISVILLE
State : KY
Zip : 40207-1255
Country : US
Telephone Number : 502-905-7495
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2015
Last Update Date : 07/07/2015

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