Provider Demographics
NPI:1255940136
Name:KOENE, SATCHI (RPH)
Entity type:Individual
Prefix:
First Name:SATCHI
Middle Name:
Last Name:KOENE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19100 MONTGOMERY VILLAGE AVE
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20886-3701
Mailing Address - Country:US
Mailing Address - Phone:301-948-6886
Mailing Address - Fax:
Practice Address - Street 1:12825 WISTERIA DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-2654
Practice Address - Country:US
Practice Address - Phone:301-540-1103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-28
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27388183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist