Healthcare Provider Details

I. General information

NPI: 1871586339
Provider Name (Legal Business Name): DARLENE HURST R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 11/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365-C CLIFTON RD NE WINSHIP INFUSION PHARMACY
ATLANTA GA
30322-1013
US

IV. Provider business mailing address

4143 DIVOT WAY
DULUTH GA
30097-8190
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-4562
  • Fax: 404-778-4571
Mailing address:
  • Phone: 678-472-6074
  • Fax: 404-778-4571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number31899
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20170
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: