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General NPI Number Information
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NPI Number | 1225182777
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Entity Type | Individual
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Provider Name | ROBERT JARED MONTIERTH PHARM D
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Gender | Male
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2125 W US HIGHWAY 70
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City | THATCHER
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State | AZ
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Zip | 85552-5446
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Country | US
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Telephone | 928-428-7244
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Fax | 928-428-7270
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Provider Business Mailing Address
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Address Line | 1390 W CRIMSON CANYON DR
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City | SAFFORD
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State | AZ
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Zip | 85546-2149
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Country | US
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Telephone | 928-348-7519
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 14826
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License Number State | AZ
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