MEDICARE: MR. KIM EDWIN KRAMER R.PH.

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
1	183500000X	Pharmacist	14560	IA

General Provider Information

NPI Number	:	1992733679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KIM EDWIN KRAMER R.PH.

Provider Business Mailing Address
First Line	:	800 W MADISON ST
Second Line	:
City	:	LAKE CITY
State	:	IA
Zip	:	51449-1021
Country	:	US
Telephone Number	:	712-464-7429
Fax Number	:

Provider Business Practice Location Address
First Line	:	507 E LAKE ST
Second Line	:
City	:	ROCKWELL CITY
State	:	IA
Zip	:	50579-1711
Country	:	US
Telephone Number	:	712-297-7337
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	12/24/2007

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