Provider Demographics
NPI:1447527312
Name:MONTGOMERY, JAMIE LEE (RPH)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEE
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 FORBES AVE
Mailing Address - Street 2:ROOM 756
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3317
Mailing Address - Country:US
Mailing Address - Phone:412-246-6160
Mailing Address - Fax:412-246-6035
Practice Address - Street 1:3501 FORBES AVE
Practice Address - Street 2:ROOM 756
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3317
Practice Address - Country:US
Practice Address - Phone:412-246-6160
Practice Address - Fax:412-246-6035
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2011-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP034802L1835P1300X
PAPP414397L1835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric