Provider Demographics
NPI:1952475881
Name:PRICE, HEATHER PEGRAM (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:PEGRAM
Last Name:PRICE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 ENGLENOOK DR
Mailing Address - Street 2:
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-3283
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:582 MONROE RD
Practice Address - Street 2:SUITE 1412
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32771-8821
Practice Address - Country:US
Practice Address - Phone:866-943-4535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL33596183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist