Provider Demographics
NPI:1568753408
Name:DROTLEFF, EDWARD L (RPH)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:L
Last Name:DROTLEFF
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 1:614 BRADSHAW AVE
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-3240
Mailing Address - Country:US
Mailing Address - Phone:330-386-6210
Mailing Address - Fax:330-386-5851
Practice Address - Street 1:614 BRADSHAW AVE
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-3240
Practice Address - Country:US
Practice Address - Phone:330-386-6210
Practice Address - Fax:330-386-5851
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03307722183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist