Healthcare Provider Details

I. General information

NPI: 1205106119
Provider Name (Legal Business Name): STEVEN ELIOT KOONTZ RPH, PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2012
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 E CENTER ST
LEXINGTON NC
27292-4402
US

IV. Provider business mailing address

3023 WINDCHASE CT
HIGH POINT NC
27265-3032
US

V. Phone/Fax

Practice location:
  • Phone: 336-237-0648
  • Fax: 336-237-0684
Mailing address:
  • Phone: 336-491-0381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10097
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: