Provider Demographics
NPI:1629327036
Name:SIEFKER, ALAN (RPH)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:SIEFKER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 E TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-5024
Mailing Address - Country:US
Mailing Address - Phone:615-289-0871
Mailing Address - Fax:
Practice Address - Street 1:9100 WHITE BLUFF RD STE 604
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-4674
Practice Address - Country:US
Practice Address - Phone:615-289-0871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA14529183500000X
NC22399183500000X
OH03-2-15276183500000X
NV15928183500000X
GARPH014529183500000X
CO16280183500000X
MEPR5390183500000X
SC12394183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist