Provider Demographics
NPI:1497055107
Name:MONTGOMERY, TRENELL (RPH)
Entity Type:Individual
Prefix:
First Name:TRENELL
Middle Name:
Last Name:MONTGOMERY
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 1:7313 DOWNMAN RD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-1213
Mailing Address - Country:US
Mailing Address - Phone:504-309-5741
Mailing Address - Fax:504-309-5587
Practice Address - Street 1:7313 DOWNMAN RD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70126-1213
Practice Address - Country:US
Practice Address - Phone:504-309-5741
Practice Address - Fax:504-309-5587
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33929183500000X
LA16071183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist