Provider Demographics
NPI:1902401102
Name:LAWANDE, HEMALI
Entity Type:Individual
Prefix:MRS
First Name:HEMALI
Middle Name:
Last Name:LAWANDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 N DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-3534
Mailing Address - Country:US
Mailing Address - Phone:563-323-1074
Mailing Address - Fax:
Practice Address - Street 1:1777 N DIVISION ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-3534
Practice Address - Country:US
Practice Address - Phone:515-209-9595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20901183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist