Provider Demographics
NPI:1104414606
Name:PENDAL, HEATHER JOY (RPH, PHARMD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:JOY
Last Name:PENDAL
Suffix:
Gender:F
Credentials:RPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 LOPATA RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-6702
Mailing Address - Country:US
Mailing Address - Phone:717-574-6119
Mailing Address - Fax:
Practice Address - Street 1:404 LOPATA RD
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-6702
Practice Address - Country:US
Practice Address - Phone:717-574-6119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-10
Last Update Date:2021-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP045598L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist