Provider Demographics
NPI:1033468475
Name:HARDISON, RHONDA G (RPH)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:G
Last Name:HARDISON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9325 E 17TH ST S
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64052-1807
Mailing Address - Country:US
Mailing Address - Phone:816-836-3688
Mailing Address - Fax:816-252-5860
Practice Address - Street 1:2301 S STERLING AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64052-3666
Practice Address - Country:US
Practice Address - Phone:816-461-1287
Practice Address - Fax:816-252-5860
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO41916183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist