# CRAMAR PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WASHINGTON PARK PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1649212267
- **Authorized official:** CRAIG HERZOG RPH (OWNER/PRESIDENT)
- **Authorized official phone:** (618) 874-1020

## Contact information

- **Practice address:** 6104 FOREST BLVD, EAST SAINT LOUIS, IL 62204-1660
- **Practice address phone:** (618) 874-1020
- **Practice address fax:** (618) 874-0204
- **Mailing address:** 6104 FOREST BLVD, EAST SAINT LOUIS, IL 62204-1660
- **Mailing address phone:** (618) 874-1020
- **Mailing address fax:** (618) 874-0204

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 054.009237 | IL | Yes |

## Other

- **Enumeration date:** 06/11/2006
- **Last updated:** 11/29/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1450155 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |