Provider Demographics
NPI:1477767424
Name:JIROUTEK, ROBERT ALAN (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ALAN
Last Name:JIROUTEK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2925 OUTLOOK DR SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-4557
Mailing Address - Country:US
Mailing Address - Phone:319-362-5489
Mailing Address - Fax:319-363-8317
Practice Address - Street 1:1520 SIXTH ST S.W.
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-4700
Practice Address - Country:US
Practice Address - Phone:319-363-0219
Practice Address - Fax:319-363-8317
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAJ14913183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist