Provider Demographics
NPI:1023618816
Name:VOLLAND LITTRELL, KIM (RPH)
Entity type:Individual
Prefix:MRS
First Name:KIM
Middle Name:
Last Name:VOLLAND LITTRELL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9675 W MARSHALL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-9102
Mailing Address - Country:US
Mailing Address - Phone:812-371-3458
Mailing Address - Fax:
Practice Address - Street 1:2025 MERCHANT MILE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-1572
Practice Address - Country:US
Practice Address - Phone:812-376-9385
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26017367A1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist