Healthcare Provider Details

I. General information

NPI: 1164921961
Provider Name (Legal Business Name): REBECCA RYAN MARCINAK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2018
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 SAVANNAH RD
LEWES DE
19958-1462
US

IV. Provider business mailing address

1515 SAVANNAH RD FL 2
LEWES DE
19958-1675
US

V. Phone/Fax

Practice location:
  • Phone: 302-260-7558
  • Fax: 302-260-7559
Mailing address:
  • Phone: 302-645-3499
  • Fax: 302-644-4830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA1-0005413
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number063436
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: