Mark Koenig, RPH
Individual provider Active NPI Pharmacist · Raymond, NH
NPI 1376826438 · NPPES record last updated Sep 26, 2011
Key facts
- NPI
- 1376826438
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- R1852 (NH)
- Practice address
- 3 Freetown Rd
Raymond, NH 03077-2394 - Phone
- (602) 895-0657
- NPI assigned
- Sep 26, 2011
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R1852 | NH | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | R1852 | NH | Yes |
Addresses
Primary practice location
3 Freetown Rd
Raymond, NH 03077-2394
Mailing address
15 Gallant Dr
Brentwood, NH 03833-6528
Phone (602) 772-3805
Other providers in Raymond, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.