Healthcare Provider Details

I. General information

NPI: 1396731154
Provider Name (Legal Business Name): DEBORAH NMN MONTAGUE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 MANNING DR
CHAPEL HILL NC
27514-4423
US

IV. Provider business mailing address

501 QUINN CT
CHAPEL HILL NC
27516-9478
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-5990
  • Fax:
Mailing address:
  • Phone: 919-929-9557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number06813
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: