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General NPI Number Information
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NPI Number | 1679494454
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Entity Type | Individual
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Provider Name | MADISON MONTAGUE PHARMD
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Gender | Female
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Dates
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Enumeration Date | 07/24/2026
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Last Update Date | 07/24/2026
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Provider Practice Location Address
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Address Line | 201 W LAYTON PKWY
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City | LAYTON
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State | UT
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Zip | 84041-3692
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Country | US
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Telephone | 801-543-6950
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Fax |
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Provider Business Mailing Address
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Address Line | 866 N 1700 W
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City | LEHI
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State | UT
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Zip | 84043-6366
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Country | US
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Telephone | 801-573-8487
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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 | 6381045-1701
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License Number State | UT
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