Provider Demographics
NPI:1083952444
Name:CRAMER, TODD EUGENE (RPH)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:EUGENE
Last Name:CRAMER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 ROSCOMMON DR
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-2849
Mailing Address - Country:US
Mailing Address - Phone:386-615-6858
Mailing Address - Fax:386-615-7261
Practice Address - Street 1:3750 ROSCOMMON DR
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-2849
Practice Address - Country:US
Practice Address - Phone:386-615-6858
Practice Address - Fax:386-615-7261
Is Sole Proprietor?:No
Enumeration Date:2013-01-19
Last Update Date:2013-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS30598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist