Provider Demographics
NPI:1700897683
Name:RICKARD, VENDONNA
Entity Type:Individual
Prefix:MRS
First Name:VENDONNA
Middle Name:
Last Name:RICKARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-3069
Mailing Address - Country:US
Mailing Address - Phone:270-821-8500
Mailing Address - Fax:270-821-8396
Practice Address - Street 1:728 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-3069
Practice Address - Country:US
Practice Address - Phone:270-821-8500
Practice Address - Fax:270-821-8396
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7854183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist