MEDICARE: KANDACE MAE SCHUFT PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	121288	MN

General Provider Information

NPI Number	:	1083372841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KANDACE MAE SCHUFT PHARMD

Provider Business Mailing Address
First Line	:	3314 HAZEL TRL UNIT B
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55129-6247
Country	:	US
Telephone Number	:	612-930-7563
Fax Number	:

Provider Business Practice Location Address
First Line	:	3314 HAZEL TRL UNIT B
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55129-6247
Country	:	US
Telephone Number	:	612-930-7563
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2021
Last Update Date	:	11/29/2021

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