Healthcare Provider Details

I. General information

NPI: 1629247036
Provider Name (Legal Business Name): HAWKEYE MEDICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/29/2008
Last Update Date: 12/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8855 ANNAPOLIS RD STE 100
LANHAM MD
20706-2931
US

IV. Provider business mailing address

8855 ANNAPOLIS RD STE 100
LANHAM MD
20706-2931
US

V. Phone/Fax

Practice location:
  • Phone: 301-918-1750
  • Fax: 301-918-1960
Mailing address:
  • Phone: 301-918-1750
  • Fax: 301-918-1960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: MR. ASHOK KAPUR
Title or Position: MANAGING MEMBER
Credential:
Phone: 301-918-1750