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General NPI Number Information
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NPI Number | 1275785248
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Entity Type | Individual
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Provider Name | AMY LYNN LITTLE PHARM D
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Gender | Female
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 10/21/2008
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Provider Practice Location Address
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Address Line | 43 WEST PRAIRIE AVE RITE AID PHARMACY
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City | HAYDEN
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State | ID
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Zip | 83835
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Country | US
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Telephone | 208-772-2774
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Fax |
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Provider Business Mailing Address
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Address Line | 43 WEST PRAIRIE AVE RITE AID PHARMACY
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City | HAYDEN
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State | ID
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Zip | 83835
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Country | US
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Telephone | 208-772-2774
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | P6198
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH60020708
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License Number State | WA
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