Provider Demographics
NPI:1730828971
Name:HAWTHORNE DRUGS LLC
Entity type:Organization
Organization Name:HAWTHORNE DRUGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YASHASWINI
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNDOOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-491-1484
Mailing Address - Street 1:11304 HAWTHORNE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-9467
Mailing Address - Country:US
Mailing Address - Phone:704-573-6899
Mailing Address - Fax:888-832-7050
Practice Address - Street 1:11304 HAWTHORNE DR STE 120
Practice Address - Street 2:
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-9467
Practice Address - Country:US
Practice Address - Phone:704-573-6899
Practice Address - Fax:888-832-7050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-03
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy