Provider Demographics
NPI:1447356282
Name:MONTAGUE, YOLANDA H (PHARMD)
Entity type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:H
Last Name:MONTAGUE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 HOLDEN WAY NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-6062
Mailing Address - Country:US
Mailing Address - Phone:770-819-7001
Mailing Address - Fax:
Practice Address - Street 1:2000 E WEST CONNECTOR
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1194
Practice Address - Country:US
Practice Address - Phone:770-819-7001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH020343183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist