Provider Demographics
NPI:1578234027
Name:KOENIGSBERG, FOREST (PHARMD)
Entity Type:Individual
Prefix:
First Name:FOREST
Middle Name:
Last Name:KOENIGSBERG
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1011
Mailing Address - Country:US
Mailing Address - Phone:828-298-3636
Mailing Address - Fax:828-298-8190
Practice Address - Street 1:805 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1011
Practice Address - Country:US
Practice Address - Phone:828-298-3636
Practice Address - Fax:828-298-8190
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30548183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist