Provider Demographics
NPI:1093098188
Name:KRAMER, ANNE MARIE (RPH)
Entity Type:Individual
Prefix:
First Name:ANNE MARIE
Middle Name:
Last Name:KRAMER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16775 SHEFFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR LAKE
Mailing Address - State:IN
Mailing Address - Zip Code:46303-9779
Mailing Address - Country:US
Mailing Address - Phone:219-696-2651
Mailing Address - Fax:
Practice Address - Street 1:1704 E COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:IN
Practice Address - Zip Code:46356-2111
Practice Address - Country:US
Practice Address - Phone:219-696-6638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-24
Last Update Date:2011-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26017983A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist