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General NPI Number Information
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NPI Number | 1851850713
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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 | 03/19/2019
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Last Update Date | 11/20/2019
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Provider Practice Location Address
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Address Line | 509 W 98TH ST
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City | BLOOMINGTON
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State | MN
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Zip | 55420-4713
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Country | US
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Telephone | 952-884-7528
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Fax |
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Provider Business Mailing Address
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Address Line | 509 W 98TH ST
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City | BLOOMINGTON
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State | MN
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Zip | 55420-4713
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Country | US
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Telephone | 952-884-7528
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Fax |
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Authorized Official
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Title or Position | OWNER/PIC
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Name | JEFFREY PAUL SCHAFFER
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Credential |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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