Healthcare Provider Details

I. General information

NPI: 1255323085
Provider Name (Legal Business Name): LATISHA TAMARA LITTLETON PHARM D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JARRETT RD TRIPLER ARMY MEDICAL CENTER
HONOLULU HI
96859-0000
US

IV. Provider business mailing address

366 RENO RD APT C
HONOLULU HI
96819-1543
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-6005
  • Fax: 808-433-6255
Mailing address:
  • Phone: 808-433-6005
  • Fax: 808-433-6255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH021420
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: