Charleston VA Cmop

Primary specialty

Department of Veterans Affairs (VA) PharmacyTaxonomy code 332100000X

Legal business name

CHARLESTON VA CMOP

Practice address

3725 Rivers Ave
Suite 2
North Charleston, SC 29405-7038

Phone

(843) 745-8631

Fax

(843) 747-6841

NPI assigned

May 4, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kenneth Siehr, R.PH., MPA

Title

Deputy Chief Consultant PBM/Cmop

Phone

(913) 758-4750

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Veterans Hosptial179 organizations share this tax ID, including this one

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1063460137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3725 RIVERS AVE",
            "address_2": "SUITE 2",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294057038",
            "telephone_number": "843-745-8631",
            "fax_number": "843-747-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3725 RIVERS AVE",
            "address_2": "SUITE 2",
            "city": "NORTH CHARLESTON",
            "state": "SC",
            "postal_code": "294057038",
            "telephone_number": "843-745-8631",
            "fax_number": "843-747-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON VA CMOP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "SIEHR",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "DEPUTY CHIEF CONSULTANT PBM/CMOP",
        "authorized_official_telephone_number": "913-758-4750",
        "authorized_official_credential": "R.PH., MPA"
    },
    "taxonomies": [
        {
            "code": "332100000X",
            "taxonomy_group": "",
            "desc": "Department of Veterans Affairs (VA) Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP#",
            "identifier": "4226153",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charleston Pediatric Dentistry, P.a.
• Charleston Pediatric Rehabilitation
• Charleston Physicians for Women PLLC
• Charleston Specialty Rehab Institute Limited Partnership
• Charleston Surgical Consultants, LLC (The Charleston Sinus Center/Russell Facial Plastic Surgery)
• Charleston Vamc
• Charleston Vamc
• Charleston Vamc
• Charleston Youth Dentistry, LLC
• Kenzie Jane Chase, RN

• Department of Veterans Affairs (VA) Pharmacy in North Charleston, SC
• Providers in North Charleston, SC by specialty
• Department of Veterans Affairs (VA) Pharmacy in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.