MEDICARE: DR. JOHN E HAWK PHARM.D, BCPS

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
1	1835P1200X	Pharmacotherapy Pharmacist	13474	CO

General Provider Information

NPI Number	:	1700871902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN E HAWK PHARM.D, BCPS

Provider Business Mailing Address
First Line	:	5167 S GENOA ST
Second Line	:
City	:	CENTENNIAL
State	:	CO
Zip	:	80015-3753
Country	:	US
Telephone Number	:	303-400-3448
Fax Number	:

Provider Business Practice Location Address
First Line	:	1055 CLERMONT ST
Second Line	:	#119
City	:	DENVER
State	:	CO
Zip	:	80220-3808
Country	:	US
Telephone Number	:	303-399-8020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	07/08/2007

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