Healthcare Provider Details

I. General information

NPI: 1578171138
Provider Name (Legal Business Name): SAMANTHA ANITA HURST PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2020
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1095 MORGAN ST
TRACY MN
56175-1037
US

IV. Provider business mailing address

2013 COUNTY ROAD 60
BALATON MN
56115-3209
US

V. Phone/Fax

Practice location:
  • Phone: 507-629-3801
  • Fax:
Mailing address:
  • Phone: 605-203-1552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number6801
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: