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General NPI Number Information
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NPI Number | 1477161917
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Entity Type | Individual
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Provider Name | CHARLES WAYNE HAWKINS JR. PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2020
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Last Update Date | 07/21/2020
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Provider Practice Location Address
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Address Line | 2669 SCENIC DR
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City | ALAMOGORDO
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State | NM
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Zip | 88310-8700
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Country | US
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Telephone | 575-439-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 2445 CHERRY HILLS DR
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City | ALAMOGORDO
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State | NM
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Zip | 88310-7738
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Country | US
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Telephone | 575-491-6924
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | IN00004047
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License Number State | NM
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