Provider Demographics
NPI:1639837149
Name:COOK, CARYN S (RPH)
Entity Type:Individual
Prefix:
First Name:CARYN
Middle Name:S
Last Name:COOK
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:CARYN
Other - Middle Name:E
Other - Last Name:SIEGFRIED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:810 TREASURY BEND DR
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-9061
Mailing Address - Country:US
Mailing Address - Phone:843-637-5024
Mailing Address - Fax:
Practice Address - Street 1:810 TREASURY BEND DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-9061
Practice Address - Country:US
Practice Address - Phone:843-637-5024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9288183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist