Healthcare Provider Details

I. General information

NPI: 1447527312
Provider Name (Legal Business Name): JAMIE LEE MONTGOMERY R.PH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2011
Last Update Date: 11/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 FORBES AVE ROOM 756
PITTSBURGH PA
15213-3317
US

IV. Provider business mailing address

3501 FORBES AVE ROOM 756
PITTSBURGH PA
15213-3317
US

V. Phone/Fax

Practice location:
  • Phone: 412-246-6160
  • Fax: 412-246-6035
Mailing address:
  • Phone: 412-246-6160
  • Fax: 412-246-6035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License NumberRP034802L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code1835P1300X
TaxonomyPsychiatric Pharmacist
License NumberPP414397L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: