Provider Demographics
NPI:1740694637
Name:MONTAGUE, JAMES PATRICK III (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PATRICK
Last Name:MONTAGUE
Suffix:III
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 1:3210 E UNION HILLS DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85050-3223
Mailing Address - Country:US
Mailing Address - Phone:602-788-4793
Mailing Address - Fax:
Practice Address - Street 1:3210 E UNION HILLS DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-3223
Practice Address - Country:US
Practice Address - Phone:602-788-4793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS019952183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist