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James Calvin Montgomery

Student in an Organized Health Care Education/Training Program

Student, Health Care

809 82nd Pkwy, Myrtle Beach, SC 29572-4607

PECOS Enrollment

This provider is enrolled in PECOS as JAMES MONTGOMERY.

Based on the most recent information from CMS, provider James Calvin Montgomery is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 4 days ago.

Profile Details

Provider ID
1043079312
Provider Type
Individual
Full Name
Montgomery, James Calvin
Credential
MD

Gender
Male
Sole Proprietor
No
Enumeration Date
3/18/2024
Last Updated
3/18/2024

Contact Information

Practice Location

809 82nd Pkwy, Myrtle Beach, SC 29572-4607

(843) 692-1595

(843) 692-1122

Mailing Location

809 82nd Pkwy, Myrtle Beach, SC 29572-4607

(843) 692-1595

(843) 692-1122

Provider Taxonomies

Code	Description	License
Code 390200000X Primary	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer South Carolina

James Calvin Montgomery

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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