=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649365701
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | LITTLETON PHARMACY INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2006
-----------------------------------------------------
Last Update Date | 07/15/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 123 E. S. MAIN ST.
-----------------------------------------------------
City | LITTLETON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27850
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-586-3414
-----------------------------------------------------
Fax | 252-586-7377
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 607
-----------------------------------------------------
City | LITTLETON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 27850-0607
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 252-586-3414
-----------------------------------------------------
Fax | 252-586-7377
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST / MANAGER
-----------------------------------------------------
Name | MR. JAMES ARNOLD KING
-----------------------------------------------------
Credential | RPH
-----------------------------------------------------
Telephone | 252-586-3414
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 03398
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------