MEDICARE: HEATHER L PECCON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RP043112L	PA

General Provider Information

NPI Number	:	1316195431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER L PECCON

Provider Business Mailing Address
First Line	:	1505 7TH AVE
Second Line	:
City	:	BEAVER FALLS
State	:	PA
Zip	:	15010-4121
Country	:	US
Telephone Number	:	724-843-6774
Fax Number	:	724-843-2818

Provider Business Practice Location Address
First Line	:	1505 7TH AVE
Second Line	:
City	:	BEAVER FALLS
State	:	PA
Zip	:	15010-4121
Country	:	US
Telephone Number	:	724-843-6774
Fax Number	:	724-843-2818

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2008
Last Update Date	:	05/26/2009

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Directions to “ HEATHER L PECCON ” Practice Location

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