SUPERVALU PHARMACIES INC (NPI# 1023123163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023123163 |
| Entity Type | Organization |
| Organization Name | SUPERVALU PHARMACIES INC |
| Other Organization Name | CUB PHARMACY |
| Practice Address |
2390 White Bear Ave N Maplewood MN 55109 |
| Mailing Address |
11840 Valley View Rd Eden Prairie MN 55344-3643 |
| Practice Telephone | 6517773113 |
| Practice Fax Number | 6517773725 |
| Mailing Telephone | 9528284588 |
| Mailing Fax Number | 9529473470 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2018-06-20 |
| Authorized Official Name | STEVE MCCANN (VP PHARMACY) |
| Authorized Official Telephone | 9528284531 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
261314 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2047399 | 01 | |
| NCPDP | 2421799 | 01 | |
| MN | 276315000 | 05 |
| Other Name | Type Code |
|---|---|
| CUB PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942831839 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 4601 Snelling Ave, Minneapolis, MN 55406-4464 | 2020-01-29 |
| 1235681958 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 10881 University Ave Ne, Blaine, MN 55434 | 2016-10-28 |
| 1740635770 | Supervalu Pharmacies Inc | Pharmacy | 421 3rd St S, Stillwater, MN 55082-4955 | 2016-04-27 |
| 1851761514 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 1920 Buerkle Rd, White Bear Lake, MN 55110 | 2015-10-06 |
| 1841685591 | Supervalu Pharmacies Inc | Pharmacy | 2612 S Broadway St, Alexandria, MN 56308-3415 | 2015-03-31 |
| 1992946446 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 10520 France Ave S, Bloomington, MN 55431-3573 | 2009-03-13 |
| 1336397298 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 1177 Clarence St, Saint Paul, MN 55106-2809 | 2008-09-04 |
| 1598912560 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 1020 Diffley Rd, Eagan, MN 55123-1777 | 2008-08-21 |
| 1104005578 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 4201 N Belt W, Belleville, IL 62226-5613 | 2007-11-01 |
| 1952580334 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 196 Mayfair Plaza Shopping Ctr, Florissant, MO 63033-8008 | 2007-11-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | SUPERVALU Pharmacies Inc. | 11840 Valley View Rd, Eden Prairie, Minnesota 55344 |
| Street Address |
2390 WHITE BEAR AVE N |
| City | MAPLEWOOD |
| State | MN |
| Zip Code | 55109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104259498 | Danny Diep | Pharmacist | 2390 White Bear Ave N, Maplewood, MN 55109-2273 | 2013-08-09 |
| 1700143708 | John Thomas Krier | Pharmacist | 2390 White Bear Ave N, Maplewood, MN 55109-2273 | 2012-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063828 | Jodi May Begordis | Registered Nurse | 2586 7th Ave East, Suite 302, North St Paul, MN 55109 | 2020-05-06 |
| 1467917146 | Alejandro Diez Freire | Social Worker | 2468 Germain St, Maplewood, MN 55109 | 2019-02-06 |
| 1679099667 | Rochelle Marie Clarke | Registered Nurse | 2586 7th Ave East Suite 302, North Saint Paul, MN 55109 | 2017-08-21 |
| 1497298210 | Salams Care Residential, LLC | Home Health | 2240 Ide Ct, Maplewood, MN 55109 | 2016-11-28 |
| 1093199630 | Garry Allen | Psychologist | 2345 Ariel St North Mail Stop 13601a, Maplewood, MN 55109 | 2015-07-14 |
| 1700264751 | Matthew Seng Thao | Student in an Organized Health Care Education/Training Program | 1470 Gervais Ave, Maplewood, MN 55109 | 2015-05-11 |
| 1326458340 | Chong Chang | Counselor | 1705 Cope Ave E Ste I, Maplewood, MN 55109 | 2014-04-29 |
| 1619396488 | Leah Anne Downey | Occupational Therapist | 2399 Ariel St. N., Children's Theraplay, LLC, Maplewood, MN 55109 | 2014-04-09 |
| 1356765440 | Group Health Plan, Inc | Clinic/Center | 2520 12th Ave E, North St Paul, MN 55109 | 2014-02-10 |
| 1336560275 | Veneman Dental Care, Pa | Dentist | 1774 Cope Ave, Suite 110, Maplewood, MN 55109 | 2013-12-19 |
| Find all providers in zip 55109 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174806756 | Walgreen Co | Pharmacy | 1633 Springfield Ave, Maplewood, NJ 07040 | 2011-09-21 |
| 1922260488 | Costco Wholesale Corporation | Pharmacy | 1431 Beam Ave, Maplewood, MN 55109-1064 | 2008-06-26 |
| 1396867545 | Topf's Maplewood Pharmacy | Pharmacy | 1885 Springfield Ave, Maplewood, NJ 07040-3419 | 2007-04-06 |
| 1588751762 | Richard John Hoyer | Pharmacy | 21 Century Ave S, Maplewood, MN 55119-5200 | 2006-10-06 |
| 1003920158 | Sun Drug Inc | Pharmacy | 2730 Stillwater Rd, Maplewood, MN 55119 | 2006-08-18 |
| 1194716548 | Maplewood Chemists, Inc | Pharmacy | 747 Irvington Ave, Maplewood, NJ 07040-1607 | 2005-11-03 |
| 1245339555 | Grand St Paul Cvs LLC | Pharmacy | 2196 White Bear Ave N, Maplewood, MN 55109-2708 | 2006-09-22 |
| 1144281304 | Minnesota Oncology Hematology Pa | Pharmacy | 1580 Beam Ave, Maplewood, MN 55109-1127 | 2006-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497368633 | Sawtooth Mountain Clinic, Inc. | Pharmacy | 513 5th Ave W Rm 201, Grand Marais, MN 55604-3017 | 2020-08-27 |
| 1891313326 | Rochester Community Pharmacy LLC | Pharmacy | 1604 1st St Nw, Rochester, MN 55901-0318 | 2020-07-10 |
| 1134745730 | Elko New Market Family Pharmacy, LLC | Pharmacy | 117 Old Town Road, Elko New Market, MN 55054 | 2020-06-19 |
| 1578187456 | Coborns Inc | Pharmacy | 15700 88th St Ne, Otsego, MN 55330 | 2020-06-05 |
| 1205460169 | Genoa Healthcare, LLC | Pharmacy | 1515 Energy Park Dr Ste 110, Saint Paul, MN 55108-5229 | 2020-02-28 |
| 1801438361 | The Duluth Clinic, Ltd. | Pharmacy | 2 Division St Ste A, Deer River, MN 56636-8779 | 2019-10-16 |
| 1265084792 | Nudak Ventures, LLC | Pharmacy | 5418 Saint Croix Trl, North Branch, MN 55056-4203 | 2019-07-15 |
| 1659938116 | Sterlingrx Inc | Pharmacy | 1312 Northland Dr Ste 500, Mendota Heights, MN 55120-1436 | 2019-05-21 |
| 1639734346 | Seward Pharmacy LLC | Pharmacy | 2209 E Lake St, Minneapolis, MN 55407-4563 | 2019-05-08 |
| 1093370694 | Minnesota Ave N Pharmacy Services Limited | Pharmacy | 226 Minnesota Ave N, Aitkin, MN 56431-1412 | 2019-05-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.