Basic Information
| Provider Information | |||||||||
| NPI: | 1326412792 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LITTLEJOHN | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | |||||||||
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| Credential: | RPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1424 LOCKHART HWY | ||||||||
| Address2: | |||||||||
| City: | UNION | ||||||||
| State: | SC | ||||||||
| PostalCode: | 293797623 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8644274492 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 513 N DUNCAN BYP | ||||||||
| Address2: | |||||||||
| City: | UNION | ||||||||
| State: | SC | ||||||||
| PostalCode: | 293798682 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8644276114 | ||||||||
| FaxNumber: | 8644276444 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2015 | ||||||||
| LastUpdateDate: | 11/22/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 4242 | SC | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.