Cramar Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

054.009237 Issued in IL

Legal business name

CRAMAR PHARMACY INC

Practice address

6104 Forest Blvd
East Saint Louis, IL 62204-1660

Phone

(618) 874-1020

Fax

(618) 874-0204

NPI assigned

Jun 11, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Craig Herzog, RPH

Title

Owner/President

Phone

(618) 874-1020

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• WASHINGTON PARK PHARMACY Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290988800000",
    "number": "1649212267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6104 FOREST BLVD",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622041660",
            "telephone_number": "618-874-1020",
            "fax_number": "618-874-0204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6104 FOREST BLVD",
            "city": "EAST SAINT LOUIS",
            "state": "IL",
            "postal_code": "622041660",
            "telephone_number": "618-874-1020",
            "fax_number": "618-874-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAMAR PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2010-11-29",
        "status": "A",
        "authorized_official_last_name": "HERZOG",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "618-874-1020",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054.009237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1450155",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WASHINGTON PARK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in East Saint Louis, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.