Provider Demographics
NPI:1346750635
Name:LITTLES HSC PHARMACY INC
Entity Type:Organization
Organization Name:LITTLES HSC PHARMACY INC
Other - Org Name:LITTLE'S HSC PHARMACY LTC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CPHT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:VALLIERES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-663-6450
Mailing Address - Street 1:109 EAGLE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-2696
Mailing Address - Country:US
Mailing Address - Phone:413-663-6450
Mailing Address - Fax:413-664-8462
Practice Address - Street 1:109 EAGLE ST
Practice Address - Street 2:
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2696
Practice Address - Country:US
Practice Address - Phone:413-663-6450
Practice Address - Fax:413-664-8462
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LITTLES HSC PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADS25513336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110021339Medicaid