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Individual

BLAKE LANIER HAWKINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM. D.

Contact information

Practice address
5895 REIDVILLE RD, MOORE, SC 29369-8409
(864) 486-6990
(864) 486-6996
Mailing address
224 CREEKRIDGE DR, SPARTANBURG, SC 29301-1212
(864) 678-0880

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
37815
SC

Other

Enumeration date
07/27/2018
Last updated
07/27/2018
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