Healthcare Provider Details

I. General information

NPI: 1184016917
Provider Name (Legal Business Name): LITTLE ACORN PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2015
Last Update Date: 12/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11161 NEW HAMPSHIRE AVE STE 110
SILVER SPRING MD
20904-2606
US

IV. Provider business mailing address

11161 NEW HAMPSHIRE AVE STE 110
SILVER SPRING MD
20904-2606
US

V. Phone/Fax

Practice location:
  • Phone: 301-592-0060
  • Fax: 301-592-0054
Mailing address:
  • Phone: 301-592-0060
  • Fax: 301-592-0054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License NumberP06806
License Number StateMD

VIII. Authorized Official

Name: AJAYKUMAR SHARMA
Title or Position: OWNER,PRESIDENT,PIC,AO
Credential: RPH
Phone: 410-979-2631