Provider Demographics
NPI:1659446904
Name:MONTGOMERY DRUG COMPANY INC
Entity Type:Organization
Organization Name:MONTGOMERY DRUG COMPANY INC
Other - Org Name:ADAMS DRUGS MEDICINE ON TIME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:LINCOLN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:334-288-5532
Mailing Address - Street 1:37 MITCHELL DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-2923
Mailing Address - Country:US
Mailing Address - Phone:334-288-5532
Mailing Address - Fax:334-386-1814
Practice Address - Street 1:37 MITCHELL DR
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-2923
Practice Address - Country:US
Practice Address - Phone:334-288-5532
Practice Address - Fax:334-386-1814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
AL1128773336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
1995958OtherPK