Provider Demographics
NPI:1255348397
Name:LEIKACH, DEANNA DIXIL (RPH)
Entity type:Individual
Prefix:
First Name:DEANNA
Middle Name:DIXIL
Last Name:LEIKACH
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 1:10821 RED RUN BLVD UNIT 1795
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-8581
Mailing Address - Country:US
Mailing Address - Phone:443-386-1062
Mailing Address - Fax:
Practice Address - Street 1:6350 FREDERICK RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-2375
Practice Address - Country:US
Practice Address - Phone:410-744-5959
Practice Address - Fax:410-744-4810
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12881183500000X
174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No174H00000XOther Service ProvidersHealth Educator