Provider Demographics
NPI:1790814671
Name:DEANHARDT, RHONDA P (RPH)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:P
Last Name:DEANHARDT
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 1:1233 WESTGATE PKWY
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-2151
Mailing Address - Country:US
Mailing Address - Phone:334-712-2000
Mailing Address - Fax:334-712-2002
Practice Address - Street 1:1233 WESTGATE PKWY
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-2151
Practice Address - Country:US
Practice Address - Phone:334-712-2000
Practice Address - Fax:334-712-2002
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist