Provider Demographics
NPI:1447651252
Name:HAWKINS, BEVERLY (RPH)
Entity type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 MAIN ST HWY 19
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:LA
Mailing Address - Zip Code:70714-3767
Mailing Address - Country:US
Mailing Address - Phone:225-774-1025
Mailing Address - Fax:225-774-1025
Practice Address - Street 1:312 MAIN ST HWY 19
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:LA
Practice Address - Zip Code:70714-3767
Practice Address - Country:US
Practice Address - Phone:225-774-1025
Practice Address - Fax:225-774-1025
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.13653183500000X
GARPH015055183500000X
MD15389183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist