MEDICARE: HAWKINS PHARMACY PC

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	332B00000X	Durable Medical Equipment & Medical Supplies
2	3336C0003X	Community/Retail Pharmacy	62-4750	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2072702	OTHER		PK

General Provider Information

NPI Number	:	1952459950
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAWKINS PHARMACY PC

Provider Business Mailing Address
First Line	:	121 S GRAND AVE
Second Line	:
City	:	CHEROKEE
State	:	OK
Zip	:	73728-2028
Country	:	US
Telephone Number	:	580-596-2411
Fax Number	:	580-596-2471

Provider Business Practice Location Address
First Line	:	121 S GRAND AVE
Second Line	:
City	:	CHEROKEE
State	:	OK
Zip	:	73728-2028
Country	:	US
Telephone Number	:	580-596-2411
Fax Number	:	580-596-2471

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HAWKINS L DAMON
Credential	:
Telephone Number	:	580-596-2411

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	10/30/2023

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Directions to “HAWKINS PHARMACY PC ” Practice Location

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