Heather Pendergraff Oldham, PHARMD
Individual provider Active NPI Pharmacist · Madisonville, KY
NPI 1790069409 · NPPES record last updated Sep 30, 2011
Key facts
- NPI
- 1790069409
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 013625 (KY)
- Practice address
- 1801 N Main St
Madisonville, KY 42431 - Phone
- (270) 821-0377
- Fax
- (270) 821-2395
- NPI assigned
- Sep 30, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013625 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 013625 | KY | Yes |
Addresses
Primary practice location
1801 N Main St
Madisonville, KY 42431
Mailing address
1801 N Main St
Madisonville, KY 42431
Phone (270) 821-0377
Other providers in Madisonville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.