# MONTGOMERY PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Grant Family Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578702668
- **Authorized official:** VINCE BARTLEY (R.PH/OWNER)
- **Authorized official phone:** (318) 646-6877

## Contact information

- **Practice address:** 19479 HIGHWAY 167, BENTLEY, LA 71407-3502
- **Practice address phone:** (318) 899-5066
- **Practice address fax:** (318) 899-5069
- **Mailing address:** PO BOX 388, BENTLEY, LA 71407-0388

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | PHY.006087-IR | LA | Yes |

## Other

- **Enumeration date:** 02/12/2009
- **Last updated:** 01/20/2017