Provider Demographics
NPI:1588981765
Name:MONETTE, JAMES E
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:MONETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 W QUINCY ST
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:MI
Mailing Address - Zip Code:49930-1404
Mailing Address - Country:US
Mailing Address - Phone:906-483-2161
Mailing Address - Fax:906-482-0797
Practice Address - Street 1:1100 W QUINCY ST
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:MI
Practice Address - Zip Code:49930-1404
Practice Address - Country:US
Practice Address - Phone:906-483-2161
Practice Address - Fax:906-482-0797
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI191541835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist