Provider Demographics
NPI:1265785489
Name:GOTT, JANET L (RPH)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:L
Last Name:GOTT
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 1:1204 E HIGHWAY 32
Mailing Address - Street 2:PO BOX 748
Mailing Address - City:SALEM
Mailing Address - State:MO
Mailing Address - Zip Code:65560-2844
Mailing Address - Country:US
Mailing Address - Phone:573-729-4091
Mailing Address - Fax:573-729-2394
Practice Address - Street 1:1204 E HIGHWAY 32
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MO
Practice Address - Zip Code:65560-2844
Practice Address - Country:US
Practice Address - Phone:573-729-4091
Practice Address - Fax:573-729-2394
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO41343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist