Provider Demographics
NPI:1700481918
Name:HAMILTON, SARA (PHARMD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 7TH AVE N APT 316
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-8848
Mailing Address - Country:US
Mailing Address - Phone:612-207-4206
Mailing Address - Fax:
Practice Address - Street 1:4445 NATHAN LN N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55442-4518
Practice Address - Country:US
Practice Address - Phone:763-557-0377
Practice Address - Fax:763-557-0470
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119444183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist