Provider Demographics
NPI:1326010075
Name:CONGDON, HEATHER BRENNAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:BRENNAN
Last Name:CONGDON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6727 WOODRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774-2937
Mailing Address - Country:US
Mailing Address - Phone:301-865-3678
Mailing Address - Fax:
Practice Address - Street 1:9640 GUDELSKY DR
Practice Address - Street 2:BUILDING I, ROOM 103
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3480
Practice Address - Country:US
Practice Address - Phone:301-738-6344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV#RP0006614183500000X
PA#RP437459183500000X
MD#16209183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist