Provider Demographics
NPI:1780037622
Name:KOENIG, KIRA (PHARM D)
Entity Type:Individual
Prefix:
First Name:KIRA
Middle Name:
Last Name:KOENIG
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 RAMSAY ST APT 1C
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27265-9019
Mailing Address - Country:US
Mailing Address - Phone:864-419-2985
Mailing Address - Fax:
Practice Address - Street 1:904 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3924
Practice Address - Country:US
Practice Address - Phone:336-887-1036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC26295183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist