Individual
JACK MOUNTAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
117 CHAPMAN ST STE 200, PROVIDENCE, RI 02905-5400
(401) 444-9909
Mailing address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1099
(617) 655-1000
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH241587
MA
1835P2201X
Ambulatory Care Pharmacist
Primary
RPH06662
RI
Other
Enumeration date
07/13/2023
Last updated
07/02/2024
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