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General NPI Number Information
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NPI Number | 1528178613
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Entity Type | Organization
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Legal Business Name | LITTLE DRUG CO INCORPORATED
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 01/28/2021
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Provider Practice Location Address
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Address Line | 412 CANAL STREET
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168
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Country | US
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Telephone | 386-428-9041
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Fax | 386-423-3290
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Provider Business Mailing Address
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Address Line | 412 CANAL STREET
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City | NEW SMYRNA BEACH
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State | FL
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Zip | 32168
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Country | US
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Telephone | 386-428-9041
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Fax | 386-423-3290
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Authorized Official
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Title or Position | PHARMACIST / PIC
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Name | DAVID LYNN SIKES
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Credential | RPH
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Telephone | 386-428-9041
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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 | PH13610
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | PH6367
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License Number State | FL
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