Provider Demographics
NPI:1245229871
Name:MONTENERY, JOHN P (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:P
Last Name:MONTENERY
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 1:8 FOX CHASE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-8209
Mailing Address - Country:US
Mailing Address - Phone:740-397-5865
Mailing Address - Fax:740-392-7576
Practice Address - Street 1:1558 COSHOCTON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-5416
Practice Address - Country:US
Practice Address - Phone:740-393-3784
Practice Address - Fax:740-393-3783
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-09639183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist