MEDICARE: KURT M WOJAK PHARM.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	13342	SC

General Provider Information

NPI Number	:	1548518111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KURT M WOJAK PHARM.D.

Provider Business Mailing Address
First Line	:	1858 REMOUNT RD
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29406-3270
Country	:	US
Telephone Number	:	843-747-5213
Fax Number	:

Provider Business Practice Location Address
First Line	:	1858 REMOUNT RD
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29406-3270
Country	:	US
Telephone Number	:	843-747-5213
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2012
Last Update Date	:	08/29/2012

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