MEDICARE: DR. CHRISTOPHER EPHREM KONIG PHARMD, MBA, RAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS63463	FL

General Provider Information

NPI Number	:	1124515762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER EPHREM KONIG PHARMD, MBA, RAC

Provider Business Mailing Address
First Line	:	4584 GRAND PRESERVE PL
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-1052
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4584 GRAND PRESERVE PL
Second Line	:
City	:	PALM HARBOR
State	:	FL
Zip	:	34684-1052
Country	:	US
Telephone Number	:	813-406-2105
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2018
Last Update Date	:	11/04/2021

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