Provider Demographics
NPI:1982690160
Name:LOGEMANN, CRAIG D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:D
Last Name:LOGEMANN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 86TH ST
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-4201
Mailing Address - Country:US
Mailing Address - Phone:515-276-3406
Mailing Address - Fax:515-276-5141
Practice Address - Street 1:2901 86TH ST
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-4201
Practice Address - Country:US
Practice Address - Phone:515-276-3406
Practice Address - Fax:515-276-5141
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17090183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist