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NPI Code Detail

MEDICARE: DR. JEREMY LOWELL HAWKES PHARMD

MEDICARE: DR. JEREMY LOWELL HAWKES PHARMD
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
1183500000XPharmacist6609157UT

General Provider Information

NPI Number : 1295018364
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEREMY LOWELL HAWKES PHARMD
Provider Business Mailing Address
First Line : 881 RED HEN RD
Second Line :
City : SARATOGA SPRINGS
State : UT
Zip : 84045-3990
Country : US
Telephone Number : 801-766-1320
Fax Number :
Provider Business Practice Location Address
First Line : 1315 N STATE ST
Second Line :
City : PROVO
State : UT
Zip : 84604-2416
Country : US
Telephone Number : 801-616-5223
Fax Number : 801-616-5252
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2011
Last Update Date : 09/23/2011

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