Healthcare Provider Details

I. General information

NPI: 1629010293
Provider Name (Legal Business Name): PAUL'S PHARMACY AND GIFTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 1ST AVE S
ST JAMES MN
56081-1726
US

IV. Provider business mailing address

418 1ST AVE S
ST JAMES MN
56081-1726
US

V. Phone/Fax

Practice location:
  • Phone: 507-375-4511
  • Fax: 507-375-4511
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number2622444
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PAUL WINDSCHILL
Title or Position: PRESIDENT
Credential: RPH
Phone: 507-375-4511