MEDICARE: SCOFIELD DRUG AND GIFT, INC.

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	333600000X	Pharmacy	BS1595973	MN

General Provider Information

NPI Number	:	1851373716
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOFIELD DRUG AND GIFT, INC.

Provider Business Mailing Address
First Line	:	108 4TH ST N
Second Line	:
City	:	CANNON FALLS
State	:	MN
Zip	:	55009-2036
Country	:	US
Telephone Number	:	507-263-2881
Fax Number	:	507-263-8702

Provider Business Practice Location Address
First Line	:	108 4TH ST N
Second Line	:
City	:	CANNON FALLS
State	:	MN
Zip	:	55009-2036
Country	:	US
Telephone Number	:	507-263-2881
Fax Number	:	507-263-8702

Authorized Official
Title or Position	:	PHARMACY OWNER
Name	:	MR. REED QUALEY
Credential	:	RPH
Telephone Number	:	507-263-2881

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	01/10/2008

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