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General NPI Number Information
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NPI Number | 1164220729
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Entity Type | Organization
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Legal Business Name | MONTGOMERY KEETON INFUSION CENTER, LLC.
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 503 W STATE ST STE A18
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City | MUSCLE SHOALS
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State | AL
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Zip | 35661-2861
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Country | US
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Telephone | 256-415-6542
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Fax | 256-415-6415
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Provider Business Mailing Address
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Address Line | 503 W STATE ST STE A18
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City | MUSCLE SHOALS
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State | AL
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Zip | 35661-2861
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Country | US
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Telephone | 256-415-6542
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Fax | 256-415-6415
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Authorized Official
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Title or Position | CEO
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Name | DR. MELISSA KEETON MONTGOMERY
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Credential | PHARM.D.
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Telephone | 256-415-6542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number |
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License Number State |
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