Look up the most recent NPI and PECOS records

Kevin Anthony Pacheco

Pharmacist

Pharmacy Service Providers

2224 Winter Woods Blvd, Winter Park, FL 32792-1933

PECOS Enrollment

Based on the most recent information from CMS, provider Kevin Anthony Pacheco does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1508154782
Provider Type
Individual
Full Name
Pacheco, Kevin Anthony
Title
Dr.
Credential
PHARMD

Gender
Male
Sole Proprietor
Yes
Enumeration Date
7/21/2011
Last Updated
7/21/2011

Contact Information

Practice Location

2224 Winter Woods Blvd, Winter Park, FL 32792-1933

(847) 971-7842

Unlisted Fax

Mailing Location

2224 Winter Woods Blvd, Winter Park, FL 32792-1933

(847) 971-7842

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 183500000X Primary	Description Pharmacist Pharmacy Service Providers	License PS46749 Florida

Provider Identifiers

ID	Description	Issuer
ID PS46749	Description Other	Issuer FLORIDA PHARMACY LICENSE NUMBER Florida

Kevin Anthony Pacheco

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Baskauskas, Susan L

Conteh, Adrene Karen

Rogers, Regina B

Williams, Briana

Le Fevre, Kate Stultz

Botes, Johannes Jacobus

Thompson, Amanda

Barrington, Gwenetta

Patel, Sanjay

Black, Victoria Marie