Provider Demographics
NPI:1457677080
Name:CROMER, JOHN HELLER (RPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:HELLER
Last Name:CROMER
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 1:2030 NW 7TH PL
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32603-1113
Mailing Address - Country:US
Mailing Address - Phone:352-335-1544
Mailing Address - Fax:
Practice Address - Street 1:2403 SW 27TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0807
Practice Address - Country:US
Practice Address - Phone:352-237-0143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0013460183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist