Provider Demographics
NPI:1386975746
Name:E.A. HAWSE HEALTH CENTER, INC
Entity type:Organization
Organization Name:E.A. HAWSE HEALTH CENTER, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:304-897-8220
Mailing Address - Street 1:PO BOX 31
Mailing Address - Street 2:
Mailing Address - City:BAKER
Mailing Address - State:WV
Mailing Address - Zip Code:26801-0031
Mailing Address - Country:US
Mailing Address - Phone:304-892-8220
Mailing Address - Fax:304-897-8210
Practice Address - Street 1:17978 STATE ROUTE 55
Practice Address - Street 2:
Practice Address - City:BAKER
Practice Address - State:WV
Practice Address - Zip Code:26801-0031
Practice Address - Country:US
Practice Address - Phone:304-897-8220
Practice Address - Fax:304-897-8210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSP05523943336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy