Provider Demographics
NPI:1124468210
Name:MONTGOMERY DRUG COMPANY INC.
Entity type:Organization
Organization Name:MONTGOMERY DRUG COMPANY INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST/GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:334-538-2484
Mailing Address - Street 1:35 MITCHELL DR
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-2923
Mailing Address - Country:US
Mailing Address - Phone:334-272-0802
Mailing Address - Fax:334-272-0882
Practice Address - Street 1:1633 PERRY HILL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-2729
Practice Address - Country:US
Practice Address - Phone:334-386-8813
Practice Address - Fax:334-386-8814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-03
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy