Provider Demographics
NPI:1831803162
Name:MOTI, JANET CHELAGAT (PHARMACIST)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:CHELAGAT
Last Name:MOTI
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 BRECKENRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:MAUMELLE
Mailing Address - State:AR
Mailing Address - Zip Code:72113-5936
Mailing Address - Country:US
Mailing Address - Phone:972-375-2611
Mailing Address - Fax:
Practice Address - Street 1:2000 JOHN HARDEN DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-2730
Practice Address - Country:US
Practice Address - Phone:501-982-3357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD15880183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist