Provider Demographics
NPI:1851373716
Name:SCOFIELD DRUG AND GIFT, INC.
Entity Type:Organization
Organization Name:SCOFIELD DRUG AND GIFT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:REED
Authorized Official - Middle Name:
Authorized Official - Last Name:QUALEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:507-263-2881
Mailing Address - Street 1:108 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:CANNON FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:55009-2036
Mailing Address - Country:US
Mailing Address - Phone:507-263-2881
Mailing Address - Fax:507-263-8702
Practice Address - Street 1:108 4TH ST N
Practice Address - Street 2:
Practice Address - City:CANNON FALLS
Practice Address - State:MN
Practice Address - Zip Code:55009-2036
Practice Address - Country:US
Practice Address - Phone:507-263-2881
Practice Address - Fax:507-263-8702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-16
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNBS1595973333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0794640001Medicare ID - Type Unspecified