Olivia B Montgomery, LPHT

Individual provider Active NPI Pharmacy Technician · Christopher, IL

NPI 1245892371 · NPPES record last updated Jun 28, 2019

Key facts

NPI
1245892371
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacy Technician 183700000X
License
049255601 (IL)
Practice address
4241 Highway 14 W
Christopher, IL 62822-1037
Phone
(618) 724-2401
NPI assigned
Jun 28, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
049255601ILMDPharmacy Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 049255601 IL Yes

Addresses

Primary practice location

4241 Highway 14 W
Christopher, IL 62822-1037

Mailing address

4241 Highway 14 W
Christopher, IL 62822-1037

Other providers in Christopher, IL

All providers in Christopher, IL · Pharmacy Technician in Illinois

Sources for this page

Verify at the official NPI Registry.