Organization
HINES 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
5000 S 5TH AVE, BLDG. 37, HINES, IL 60141-3030
(708) 786-7821
(708) 786-7980
Mailing address
5000 S 5TH AVE, BLDG. 37, HINES, IL 60141-3030
(708) 786-7820
(708) 786-7980
Taxonomy
Speciality
Code
Description
License number
State
332100000X
Department of Veterans Affairs (VA) Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1478367
NCPDP#
IL
Enumeration date
05/05/2006
Last updated
03/07/2023
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