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Contact Information

HAWKS PRAIRIE PHARMACY
2539 MARVIN RD NE
STE E
LACEY, WA98516-3177
 Phone: 360-438-3072
 Fax: 360-438-3532
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Clinic/Center

261Q00000X
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Managed Care Organization Pharmacy

3336M0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for HAWKS PRAIRIE PHARMACY

NPI Number 1508292707
LBN Legal business name HAWKS PRAIRIE PHARMACY
Authorized official SUNIL THIMMEGOWDA - (OWNER/PHARMACIST)
Entity Organization
Organization subpart 1 No
Enumeration date 09/19/2013
Last updated 11/11/2023 - About 3 years ago
Identifiers
WA License # PHAR.CF.60409528
WA Other G8924654 MEDICARE MASS IMMUNIZATION
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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