MEDICARE: LITTLETON PHARMACY INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	03398	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649365701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITTLETON PHARMACY INC.

Provider Business Mailing Address
First Line	:	PO BOX 607
Second Line	:
City	:	LITTLETON
State	:	NC
Zip	:	27850-0607
Country	:	US
Telephone Number	:	252-586-3414
Fax Number	:	252-586-7377

Provider Business Practice Location Address
First Line	:	123 E. S. MAIN ST.
Second Line	:
City	:	LITTLETON
State	:	NC
Zip	:	27850
Country	:	US
Telephone Number	:	252-586-3414
Fax Number	:	252-586-7377

Authorized Official
Title or Position	:	PHARMACIST / MANAGER
Name	:	MR. JAMES ARNOLD KING
Credential	:	RPH
Telephone Number	:	252-586-3414

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/15/2008

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Directions to “LITTLETON PHARMACY INC. ” Practice Location

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