| NPI | 1508292707 |
|---|---|
| Doing Business As | HAWKS PRAIRIE HEALTH MART PHARMACY |
| Entity Type | Organization |
| Authorized Contact | SUNIL B THIMMEGOWDA Owner/Pharmacist 360-438-3072 |
| Organization Subpart ? | No |
| Primary Taxonomy | 333600000X Pharmacy (Licence: WA PHAR.CF.60409528) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 3336M0003X Pharmacy, Managed Care Organization Pharmacy | |
| Enumeration Date | 2013-09-19 |
| Last Update Date | 2023-11-11 |