Healthcare Provider Details

I. General information

NPI: 1710759055
Provider Name (Legal Business Name): RASHAD HAWKINS CCL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RASHAD HAWKINS CARDIAC CATH LAB

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 10/30/2023
Certification Date: 10/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4575 WEBB BRIDGE RD
ALPHARETTA GA
30005-4256
US

IV. Provider business mailing address

PO BOX 5695
ALPHARETTA GA
30023-5695
US

V. Phone/Fax

Practice location:
  • Phone: 404-491-9116
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: