Healthcare Provider Details

I. General information

NPI: 1700977246
Provider Name (Legal Business Name): SCHNEIDER DRUG
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 EAST BROWN
COMFREY MN
56159
US

IV. Provider business mailing address

PO BOX 247 113 EAST BROWN
COMFREY MN
56159
US

V. Phone/Fax

Practice location:
  • Phone: 507-877-4791
  • Fax: 507-877-2023
Mailing address:
  • Phone: 507-877-4791
  • Fax: 507-877-2023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2614287
License Number StateMN

VIII. Authorized Official

Name: MR. CHARLES A LEHMAN
Title or Position: OWNER RPH
Credential: RPH
Phone: 507-877-4791