Provider Demographics
NPI:1730667965
Name:PERDUE, QUINTARIOUS MARQUEZ (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:QUINTARIOUS
Middle Name:MARQUEZ
Last Name:PERDUE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7912 BERRYHILL CT APT D
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7736
Mailing Address - Country:US
Mailing Address - Phone:334-309-6772
Mailing Address - Fax:
Practice Address - Street 1:1734 CARTER HILL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-2002
Practice Address - Country:US
Practice Address - Phone:334-263-3818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19978183500000X, 1835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist