Healthcare Provider Details

I. General information

NPI: 1386031458
Provider Name (Legal Business Name): THOMAS HAWKINS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 NC HIGHWAY 88 W # 288
WARRENSVILLE NC
28693-9209
US

IV. Provider business mailing address

5121 NC HIGHWAY 88 W # 288
WARRENSVILLE NC
28693-9209
US

V. Phone/Fax

Practice location:
  • Phone: 336-384-3900
  • Fax: 336-384-4041
Mailing address:
  • Phone: 336-384-3900
  • Fax: 336-384-4041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number06789
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: