Provider Demographics
NPI:1053821421
Name:HOOKS, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:HOOKS
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 1:525 GREY HAWK LN
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-7133
Mailing Address - Country:US
Mailing Address - Phone:321-917-9690
Mailing Address - Fax:
Practice Address - Street 1:2240 W DEKALB ST
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:SC
Practice Address - Zip Code:29020-2069
Practice Address - Country:US
Practice Address - Phone:803-425-1691
Practice Address - Fax:803-425-4096
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-11
Last Update Date:2017-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37278183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist