Provider Demographics
NPI:1124432463
Name:SCHRAMM, TRACEY
Entity type:Individual
Prefix:
First Name:TRACEY
Middle Name:
Last Name:SCHRAMM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6513 TYDINGS RD
Mailing Address - Street 2:
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6110
Mailing Address - Country:US
Mailing Address - Phone:410-857-9000
Mailing Address - Fax:410-857-9597
Practice Address - Street 1:400 ENGLAR RD
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6185
Practice Address - Country:US
Practice Address - Phone:410-857-9000
Practice Address - Fax:410-857-9597
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-15
Last Update Date:2014-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12859183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist