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Individual

BENJAMIN KOENIG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
3020 CLAIRMONT AVE S, BIRMINGHAM, AL 35205-1113
(205) 323-6823
Mailing address
4841 WILLIAMSON RD NW, ROANOKE, VA 24012-2331
(540) 265-8922

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202215770
VA
183500000X
Pharmacist
Primary
22497
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0202215770
PHARMACIST LICENSE
VA
Enumeration date
10/19/2021
Last updated
12/21/2022
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