Healthcare Provider Details

I. General information

NPI: 1851373716
Provider Name (Legal Business Name): SCOFIELD DRUG AND GIFT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 01/10/2008
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 Code333600000X
TaxonomyPharmacy
License NumberBS1595973
License Number StateMN

VIII. Authorized Official

Name: MR. REED QUALEY
Title or Position: PHARMACY OWNER
Credential: RPH
Phone: 507-263-2881