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General NPI Number Information
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NPI Number | 1467189811
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Entity Type | Organization
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Legal Business Name | MONTAGUE APOTHECARY CORP.
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Dates
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Enumeration Date | 08/05/2022
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Last Update Date | 08/05/2022
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Provider Practice Location Address
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Address Line | 152 MONTAGUE ST
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City | BROOKLYN
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State | NY
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Zip | 11201-3540
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Country | US
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Telephone | 718-400-2001
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Fax | 347-463-9663
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Provider Business Mailing Address
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Address Line | 152 MONTAGUE ST
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City | BROOKLYN
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State | NY
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Zip | 11201-3540
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Country | US
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Telephone | 718-400-2001
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Fax | 347-463-9663
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Authorized Official
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Title or Position | V. PRESIDENT
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Name | MR. AZAR KAMKHEHJI
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Credential | RPH
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Telephone | 917-887-2467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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