Provider Demographics
NPI:1437430956
Name:LITTLE, ROBIN TUCKERMAN (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:TUCKERMAN
Last Name:LITTLE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15609 LAKE SHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44110-1003
Mailing Address - Country:US
Mailing Address - Phone:216-383-3803
Mailing Address - Fax:216-383-0253
Practice Address - Street 1:15609 LAKE SHORE BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44110-1003
Practice Address - Country:US
Practice Address - Phone:216-383-3803
Practice Address - Fax:216-383-0253
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03127547183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist