Healthcare Provider Details

I. General information

NPI: 1265579643
Provider Name (Legal Business Name): SCOFIELD DRUG & GIFT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 01/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 4TH ST N
CANNON FALLS MN
55009-2036
US

IV. Provider business mailing address

108 4TH ST N
CANNON FALLS MN
55009-2036
US

V. Phone/Fax

Practice location:
  • Phone: 507-263-2881
  • Fax: 507-263-8702
Mailing address:
  • Phone: 507-263-2881
  • Fax: 507-263-8702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number2605296
License Number StateMN

VIII. Authorized Official

Name: MR. REED RICHARD QUALEY
Title or Position: PRESIDENT
Credential: PHARMACIST
Phone: 507-263-2881