Provider Demographics
NPI:1912360389
Name:LEWIS HAWK DISTRIBUTION INC
Entity Type:Organization
Organization Name:LEWIS HAWK DISTRIBUTION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MARR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-254-7395
Mailing Address - Street 1:222 INDUSTRIAL AVE
Mailing Address - Street 2:
Mailing Address - City:HOHENWALD
Mailing Address - State:TN
Mailing Address - Zip Code:38462-2468
Mailing Address - Country:US
Mailing Address - Phone:858-254-7395
Mailing Address - Fax:
Practice Address - Street 1:222 INDUSTRIAL AVE
Practice Address - Street 2:
Practice Address - City:HOHENWALD
Practice Address - State:TN
Practice Address - Zip Code:38462-2468
Practice Address - Country:US
Practice Address - Phone:858-254-7395
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies