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NPI Code Detail

MEDICARE: CHLOE S MONTGOMERY

MEDICARE: CHLOE S MONTGOMERY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPST.022575LA

General Provider Information

NPI Number : 1760961015
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHLOE S MONTGOMERY
Provider Business Mailing Address
First Line : 30399 SAINT JOHN DR
Second Line :
City : LACOMBE
State : LA
Zip : 70445-2859
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2050 FLORIDA ST
Second Line :
City : MANDEVILLE
State : LA
Zip : 70448-5234
Country : US
Telephone Number : 985-951-7282
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2018
Last Update Date : 08/08/2018

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Directions to “ CHLOE S MONTGOMERY ” Practice Location

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