OrganizationActive
Va Cmop
NPI 1104076694 · Mail Order Pharmacy · North Charleston, SC
Provider details
- NPI number
- 1104076694
- Entity type
- Organization
- Primary specialty
- Mail Order PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Dena Wolforth, Program Manager(843) 745-8636
Specialties & taxonomies
Suppliers
- Health Maintenance Organization302R00000X
Managed Care Organizations
Practice location
3725 Rivers Ave Ste 2
North Charleston, SC 29405-7072
Phone: (843) 745-8649
Approximate (ZIP-level) locationGet directions
Mailing address
3725 Rivers Ave Ste 2
North Charleston, SC 29405-7072
Registry dates
- Enumerated
- 2008-09-22
- Last updated
- 2008-09-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.