Provider Demographics
NPI:1841549771
Name:HAWKINS, VICKI
Entity type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:
Last Name:HAWKINS
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 1:87 GARNER RD
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-0000
Mailing Address - Country:US
Mailing Address - Phone:864-583-5428
Mailing Address - Fax:864-597-1498
Practice Address - Street 1:87 GARNER RD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-0000
Practice Address - Country:US
Practice Address - Phone:864-583-5428
Practice Address - Fax:864-597-1498
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6186183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist