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Organization

CHARLESTON VA CMOP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KENNETH SIEHR R.PH., MPA (DEPUTY CHIEF CONSULTANT PBM/CMOP)
(913) 758-4750
Entity
Organization

Contact information

Practice address
3725 RIVERS AVE, SUITE 2, NORTH CHARLESTON, SC 29405-7038
(843) 745-8631
(843) 747-6841
Mailing address
3725 RIVERS AVE, SUITE 2, NORTH CHARLESTON, SC 29405-7038
(843) 745-8631
(843) 747-6841

Taxonomy

Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4226153
NCPDP#
SC
Enumeration date
05/04/2006
Last updated
03/07/2023
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