Gustafson, Samantha

Gustafson, Samantha is an sole proprietor health care provider with primary practice located at 24760 Hospital Drive , Red Lake MN 56671. She recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist, Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist. Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist is her primary health care specialty. Gustafson, Samantha can be contacted via phone (218) 679-2825.

Contact Information

Primary practice address
24760 Hospital Drive Red Lake MN 56671
Phone: (218) 679-2825
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 119413 Minnesota
Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 119413 Minnesota

Profile Details

NPI number 1326334525
LBN Legal business name Gustafson, Samantha
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 26th, 2011
Last updated May 11th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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