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General NPI Number Information
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NPI Number | 1578505350
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Entity Type | Organization
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Legal Business Name | LITTLE & WADDELL INC
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 5291 KENTUCKY ROUTE 321
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City | PRESTONSBURG
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State | KY
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Zip | 41653-9168
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Country | US
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Telephone | 606-886-9954
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Fax | 606-889-9404
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Provider Business Mailing Address
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Address Line | PO BOX 1349
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City | PRESTONSBURG
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State | KY
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Zip | 41653-5349
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Country | US
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Telephone | 606-889-9003
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Fax | 606-889-9404
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Authorized Official
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Title or Position | PRESIDENT OWNER PHARMACIST
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Name | MR. PAUL D REFFETT
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Credential | R.PH.
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Telephone | 606-889-9003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | PO7635
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | PO7635
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License Number State | KY
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