Provider Demographics
NPI:1629089131
Name:SCHNEIDER DRUG
Entity Type:Organization
Organization Name:SCHNEIDER DRUG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:LEHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:507-877-4791
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:COMFREY
Mailing Address - State:MN
Mailing Address - Zip Code:56019-0247
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:113 E BROWN ST
Practice Address - Street 2:
Practice Address - City:COMFREY
Practice Address - State:MN
Practice Address - Zip Code:56019-1147
Practice Address - Country:US
Practice Address - Phone:507-877-4791
Practice Address - Fax:507-877-4791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2614287333600000X
3336C0003X, 3336M0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Not Answered3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2404248OtherOTHER ID NUMBER-COMMERCIAL NUMBER
1247620001Medicare ID - Type Unspecified