Provider Demographics
NPI:1861488728
Name:PECHACEK, DEBORAH S (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:S
Last Name:PECHACEK
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 1:133 SEA ISLE CIR
Mailing Address - Street 2:
Mailing Address - City:SOUTH DAYTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32119-2228
Mailing Address - Country:US
Mailing Address - Phone:321-663-1427
Mailing Address - Fax:
Practice Address - Street 1:821 N US HIGHWAY 1 STE A-1
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-4561
Practice Address - Country:US
Practice Address - Phone:833-886-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS24380183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist