Organization
HAWKS PRAIRIE PHARMACY
Active
Parent organization
HAWKS PRAIRIE PHARMACY
Other names
HAWKS PRAIRIE LTC PHARMACY, HAWKS PRAIRIE HEALTH MART PHARMACY
Organization subpart
Yes
Provider details
NPI number
Legal business name
HAWKS PRAIRIE PHARMACY
Authorized official
SUNIL B THIMMEGOWDA RPH (PRESIDENT)
(360) 438-3072
Entity
Organization
Contact information
Practice address
2539 MARVIN RD NE STE E, LACEY, WA 98516-3175
(360) 438-3072
(360) 438-3532
Mailing address
2539 MARVIN RD NE STE E, LACEY, WA 98516-3175
(360) 438-3072
(360) 438-3532
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508292707
NPI
—
05
—
2031538
—
WA
Enumeration date
07/14/2022
Last updated
07/16/2022
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