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General NPI Number Information
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NPI Number | 1972086676
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Entity Type | Individual
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Provider Name | TAMRA LEISHEAR LITTLE PHARM.D. R.PH.
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Gender | Female
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Dates
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Enumeration Date | 09/10/2018
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Last Update Date | 09/10/2018
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Provider Practice Location Address
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Address Line | 800 FOXCROFT AVE
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City | MARTINSBURG
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State | WV
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Zip | 25401-1829
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Country | US
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Telephone | 304-263-6030
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Fax |
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Provider Business Mailing Address
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Address Line | 272 MCCULLOUGH ST APT B4
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City | MORGANTOWN
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State | WV
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Zip | 26505-7339
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Country | US
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Telephone | 304-261-5055
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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 | RP0010551
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License Number State | WV
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