Healthcare Provider Details

I. General information

NPI: 1740338334
Provider Name (Legal Business Name): JEFFREY PAUL SCHAFFER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 W 98TH ST BLOOMINGTON DRUG PHARMACY
BLOOMINGTON MN
55420-4713
US

IV. Provider business mailing address

4144 BRYANT AVE S APT 1
MINNEAPOLIS MN
55409-1451
US

V. Phone/Fax

Practice location:
  • Phone: 952-884-7528
  • Fax: 952-884-6366
Mailing address:
  • Phone: 952-884-7528
  • Fax: 952-884-6366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number118743
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: