| Organization Name: | CHARLESTON VA CMOP |
| NPI Number: | 1063460137 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENNETH SIEHR (DEPUTY CHIEF CONSULTANT PBM/CMOP) |
| Mailing Address: | 3725 Rivers Ave Suite 2 North Charleston |
| State: | SC US |
| Postal Code: | 294057038 |
| Phone Number: | 8437458631 |
| Fax Number: | 8437476841 |
| NPI Enumeration Date: | 05/04/2006 |
| NPI Last Update Date: | 12/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Department of Veterans Affairs (VA) Pharmacy |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Department of Veterans Affairs (VA) Pharmacy means any place under VA jurisdiction where drugs are dispensed and Pharmaceutical Care is provided to enrolled Veterans, by licensed pharmacists. The Pharmacy is reviewed by JCAHO, utilizes the VA hospital |