Provider Demographics
NPI:1972086676
Name:LITTLE, TAMRA LEISHEAR (PHARMD RPH)
Entity Type:Individual
Prefix:DR
First Name:TAMRA
Middle Name:LEISHEAR
Last Name:LITTLE
Suffix:
Gender:F
Credentials:PHARMD RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 MCCULLOUGH ST APT B4
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26505-7339
Mailing Address - Country:US
Mailing Address - Phone:304-261-5055
Mailing Address - Fax:
Practice Address - Street 1:800 FOXCROFT AVE
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-1829
Practice Address - Country:US
Practice Address - Phone:304-263-6030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0010551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist