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SUSAN VIRGINIA KOONTZ PHARMD
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1215586110
Individual Registrant: SUSAN VIRGINIA KOONTZ PHARMD
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
152 SW SIERRA CT FORT WHITE, FL 32038-2772 US
Tel: 352-494-9291 Fax: --
Tel: 352-494-9291 Fax: --
Contact information for business:
152 SW SIERRA CT FORT WHITE, FL 32038-2772 US
Tel: 352-494-9291 Fax: --
Tel: 352-494-9291 Fax: --
Registration Information:
NPI: 1215586110
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | FL | PS55210 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
