Provider Demographics
NPI:1578986204
Name:KOENIGSKNECHT, AMBER (PHARMD)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:KOENIGSKNECHT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:KOENIGSKNECHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:13677 W TOWNSEND RD
Mailing Address - Street 2:
Mailing Address - City:FOWLER
Mailing Address - State:MI
Mailing Address - Zip Code:48835-9265
Mailing Address - Country:US
Mailing Address - Phone:989-640-6046
Mailing Address - Fax:
Practice Address - Street 1:101 W TOWNSEND RD
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:MI
Practice Address - Zip Code:48879-9200
Practice Address - Country:US
Practice Address - Phone:899-403-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-31
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy