Provider Demographics
NPI:1174864565
Name:LITTLEJOHN, AMONTE B (RPH)
Entity type:Individual
Prefix:MR
First Name:AMONTE
Middle Name:B
Last Name:LITTLEJOHN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3371 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-2535
Mailing Address - Country:US
Mailing Address - Phone:216-375-3313
Mailing Address - Fax:
Practice Address - Street 1:3371 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND HTS
Practice Address - State:OH
Practice Address - Zip Code:44118-2535
Practice Address - Country:US
Practice Address - Phone:216-375-3313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-10710183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist