Provider Demographics
NPI:1366614307
Name:CHENOWETH, DEBORAH LOUISE (RPH)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LOUISE
Last Name:CHENOWETH
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 1:1145 HOMESTEAD RD N
Mailing Address - Street 2:
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-6039
Mailing Address - Country:US
Mailing Address - Phone:239-368-2100
Mailing Address - Fax:239-368-2285
Practice Address - Street 1:1145 HOMESTEAD RD N
Practice Address - Street 2:
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-6039
Practice Address - Country:US
Practice Address - Phone:239-368-2100
Practice Address - Fax:239-368-2285
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS43436183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS00043436OtherLICENSE