Provider Demographics
NPI:1083389092
Name:MONTERO, ADRIAN (RPH)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:MONTERO
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 1:2216 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EMMETSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:50536-2447
Mailing Address - Country:US
Mailing Address - Phone:712-852-2886
Mailing Address - Fax:
Practice Address - Street 1:2216 MAIN ST
Practice Address - Street 2:
Practice Address - City:EMMETSBURG
Practice Address - State:IA
Practice Address - Zip Code:50536-2447
Practice Address - Country:US
Practice Address - Phone:712-852-2886
Practice Address - Fax:712-852-2534
Is Sole Proprietor?:No
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA24229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA24229OtherIOWA BOARD OR PHARMACY