Organization
CRAMAR PHARMACY INC
Active
Other names
WASHINGTON PARK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG HERZOG RPH (OWNER/PRESIDENT)
(618) 874-1020
Entity
Organization
Contact information
Practice address
6104 FOREST BLVD, EAST SAINT LOUIS, IL 62204-1660
(618) 874-1020
(618) 874-0204
Mailing address
6104 FOREST BLVD, EAST SAINT LOUIS, IL 62204-1660
(618) 874-1020
(618) 874-0204
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054.009237
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1450155
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/11/2006
Last updated
11/29/2010
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