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General NPI Number Information
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NPI Number | 1861025371
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Entity Type | Individual
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Provider Name | ADDIE MARIE LITTRELL PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/13/2020
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Last Update Date | 02/13/2020
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Provider Practice Location Address
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Address Line | 624 S CHURCH STREET PHARMACY DEPARTMENT
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City | WATERTOWN
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State | WI
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Zip | 53094
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Country | US
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Telephone | 920-261-7140
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Fax | 920-261-8223
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Provider Business Mailing Address
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Address Line | 624 S CHURCH STREET PHARMACY DEPARTMENT
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City | WATERTOWN
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State | WI
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Zip | 53094
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Country | US
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Telephone | 920-261-7140
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Fax | 920-261-8223
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 03337344
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 19666-40
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License Number State | WI
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