MEDICARE: MR. GREGORY JOSEPH SCHOUWEILER PHARMACIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	112153	MN

General Provider Information

NPI Number	:	1790007524
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GREGORY JOSEPH SCHOUWEILER PHARMACIST

Provider Business Mailing Address
First Line	:	4000 90TH ST E
Second Line	:
City	:	INVER GROVE HEIGHTS
State	:	MN
Zip	:	55076-3727
Country	:	US
Telephone Number	:	651-455-6440
Fax Number	:

Provider Business Practice Location Address
First Line	:	102 5TH AVE S
Second Line	:
City	:	SOUTH ST PAUL
State	:	MN
Zip	:	55075-2332
Country	:	US
Telephone Number	:	651-455-4140
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2010
Last Update Date	:	02/21/2010

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