Provider Demographics
NPI:1447865043
Name:KREAMER, COLTON DOUGLAS (PHARM D)
Entity type:Individual
Prefix:
First Name:COLTON
Middle Name:DOUGLAS
Last Name:KREAMER
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 42
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MT
Mailing Address - Zip Code:59638-0042
Mailing Address - Country:US
Mailing Address - Phone:406-465-9387
Mailing Address - Fax:
Practice Address - Street 1:2600 WINNE AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4900
Practice Address - Country:US
Practice Address - Phone:406-422-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT709843336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy