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General NPI Number Information
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NPI Number | 1689602674
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Entity Type | Organization
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Legal Business Name | BLOOMINGTON DRUG CO
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 09/27/2011
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Provider Practice Location Address
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Address Line | 509 WEST 98TH STREET BLOOMINGTON DRUG
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City | BLOOMINGTON
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State | MN
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Zip | 55420
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Country | US
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Telephone | 952-884-7528
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Fax | 952-884-6366
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Provider Business Mailing Address
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Address Line | 509 WEST 98TH STREET BLOOMINGTON DRUG
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City | BLOOMINGTON
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State | MN
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Zip | 55420
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Country | US
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Telephone | 952-884-7528
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Fax | 952-884-6366
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Authorized Official
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Title or Position | PRESIDENT PIC
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Name | MR. PAUL W SCHAFFER
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Credential | RPH
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Telephone | 952-884-7528
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 2003872
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License Number State | MN
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