Provider Demographics
NPI:1346519881
Name:ARUTLA, JYOTHI (RPH)
Entity Type:Individual
Prefix:
First Name:JYOTHI
Middle Name:
Last Name:ARUTLA
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 1:200 BANNING ST STE 100
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3486
Mailing Address - Country:US
Mailing Address - Phone:302-734-9303
Mailing Address - Fax:
Practice Address - Street 1:200 BANNING ST STE 100
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3486
Practice Address - Country:US
Practice Address - Phone:302-734-9303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-28
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA1-0003784183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist