Healthcare Provider Details

I. General information

NPI: 1821903600
Provider Name (Legal Business Name): LOGAN ADAM LITTLETON PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 N BROADWAY ST
PITTSBURG KS
66762-2811
US

IV. Provider business mailing address

1911 N BROADWAY ST
PITTSBURG KS
66762-2811
US

V. Phone/Fax

Practice location:
  • Phone: 620-231-1486
  • Fax:
Mailing address:
  • Phone: 620-231-1486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number1115674
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: