Provider Demographics
NPI:1023337748
Name:KRAEMER, JAMES PAUL (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:PAUL
Last Name:KRAEMER
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 1:467 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-3030
Mailing Address - Country:US
Mailing Address - Phone:781-289-8656
Mailing Address - Fax:
Practice Address - Street 1:467 BROADWAY
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-3030
Practice Address - Country:US
Practice Address - Phone:781-289-8656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20216183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist