Healthcare Provider Details

I. General information

NPI: 1730780131
Provider Name (Legal Business Name): ANDREA LITTLEJOHN HITZEMAN PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2020
Last Update Date: 11/03/2020
Certification Date: 11/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 HWY 27 N BYP
BREMEN GA
30110-1950
US

IV. Provider business mailing address

86 S CREEK CT
CARROLLTON GA
30117-4806
US

V. Phone/Fax

Practice location:
  • Phone: 770-537-2131
  • Fax: 770-537-2135
Mailing address:
  • Phone: 803-240-9099
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH023381
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11231
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: