Provider Demographics
NPI:1497162531
Name:HOWARD, MONTY (RPH)
Entity Type:Individual
Prefix:
First Name:MONTY
Middle Name:
Last Name:HOWARD
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 1:901 ROW RIVER RD
Mailing Address - Street 2:
Mailing Address - City:COTTAGE GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97424-9558
Mailing Address - Country:US
Mailing Address - Phone:541-942-0940
Mailing Address - Fax:541-767-0213
Practice Address - Street 1:901 ROW RIVER RD
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:OR
Practice Address - Zip Code:97424-9558
Practice Address - Country:US
Practice Address - Phone:541-942-0940
Practice Address - Fax:541-767-0213
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-22
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-9794183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist