Provider Demographics
NPI:1821419136
Name:CREMARD, FIORE III (PHARMD)
Entity type:Individual
Prefix:DR
First Name:FIORE
Middle Name:
Last Name:CREMARD
Suffix:III
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 1:210 E MORTON ST
Mailing Address - Street 2:
Mailing Address - City:OLD FORGE
Mailing Address - State:PA
Mailing Address - Zip Code:18518-1941
Mailing Address - Country:US
Mailing Address - Phone:570-457-5517
Mailing Address - Fax:
Practice Address - Street 1:210 E MORTON ST
Practice Address - Street 2:
Practice Address - City:OLD FORGE
Practice Address - State:PA
Practice Address - Zip Code:18518-1941
Practice Address - Country:US
Practice Address - Phone:570-457-5517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-05
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP045607L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist