Organization
MONTGOMERY RX INC
Active
Other names
Medicap Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ED MONTGOMERY DPH (OWNER PHARMACIST)
(901) 873-3200
Entity
Organization
Contact information
Practice address
4771 NAVY RD, MILLINGTON, TN 38053-1903
(901) 873-3200
(901) 873-0813
Mailing address
4771 NAVY RD, MILLINGTON, TN 38053-1903
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
C3202
TN
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1454273
—
TN
05
—
1487748794
—
TN
01
—
4430966
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
10/03/2006
Last updated
03/07/2023
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