Healthcare Provider Details
I. General information
NPI: 1740116789
Provider Name (Legal Business Name): BLOOMINGTON DRUG CO.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
509 W 98TH ST
BLOOMINGTON MN
55420-4713
US
IV. Provider business mailing address
509 W 98TH ST
BLOOMINGTON MN
55420-4713
US
V. Phone/Fax
- Phone: 952-884-7528
- Fax: 952-884-6366
- Phone: 952-884-7528
- Fax: 952-884-6366
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0004X |
| Taxonomy | Compounding Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JEFFREY
SCHAFFER
Title or Position: OWNER/PIC
Credential:
Phone: 612-611-9875