Provider Demographics
NPI:1760866966
Name:MONTGOMERY, JAMES (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:MONTGOMERY
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 1:29800 BAINBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-2202
Mailing Address - Country:US
Mailing Address - Phone:440-519-3011
Mailing Address - Fax:
Practice Address - Street 1:29800 BAINBRIDGE RD
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:OH
Practice Address - Zip Code:44139-2202
Practice Address - Country:US
Practice Address - Phone:440-519-3011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-17
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC24254183500000X
OH031362991835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No183500000XPharmacy Service ProvidersPharmacist