Healthcare Provider Details

I. General information

NPI: 1457681595
Provider Name (Legal Business Name): EMILY ANN SCHULZE KOENEKE PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/13/2010
Last Update Date: 05/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CMR 402 LANDSTUHL REGIONAL MEDICAL CENTER
APO AE
09180
US

IV. Provider business mailing address

CMR 402 BOX 2090
APO AE
09180-2090
US

V. Phone/Fax

Practice location:
  • Phone: 011496371867570
  • Fax:
Mailing address:
  • Phone: 919-745-9921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60102055
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19289
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: