GRAND ST PAUL CVS LLC (NPI# 1033131727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033131727 |
| Entity Type | Organization |
| Organization Name | GRAND ST PAUL CVS LLC |
| Other Organization Name | CVS PHARMACY #17118 |
| Practice Address |
2000 Bunker Lake Blvd Nw Andover MN 55304-4014 |
| Mailing Address |
1 Cvs Dr Mail Code 1090 Woonsocket RI 02895-6146 |
| Practice Telephone | 7638520114 |
| Practice Fax Number | 7638520114 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2016-11-15 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
2625849 | MN | Suppliers |
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 024977700 | 05 | |
| PK | 2048562 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #17118 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437620903 | Grand St Paul Cvs LLC | Pharmacy | 17435 County Road 6, Plymouth, MN 55447-3046 | 2018-12-10 |
| 1174065007 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 30 Fairview Ave S, Saint Paul, MN 55105-1463 | 2016-11-09 |
| 1316327042 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 740 Railroad Ave, Albany, MN 56307-9456 | 2015-06-08 |
| 1194126995 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 1411 Vermillion, Hastings, MN 55033 | 2014-09-11 |
| 1952715096 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 1215 E Superior St, Duluth, MN 55802-2218 | 2014-06-17 |
| 1598101362 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 25 2nd St Ne, Aitkin, MN 56431-1419 | 2013-05-20 |
| 1326392762 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 1000 Nicollet Mall # 0272, Minneapolis, MN 55403-2542 | 2012-11-07 |
| 1093060725 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 4528 Grand Ave, Duluth, MN 55807-2740 | 2012-07-18 |
| 1821356171 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 2323 Highway 3 S, Northfield, MN 55057-5172 | 2012-04-24 |
| 1861760738 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 6540 Penn Ave S, Richfield, MN 55423-1143 | 2011-12-07 |
| Street Address |
2000 BUNKER LAKE BLVD NW |
| City | ANDOVER |
| State | MN |
| Zip Code | 55304-4014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356715635 | Rachel Grimm | Pharmacist | 2000 Bunker Lake Blvd Nw, Andover, MN 55304-4014 | 2015-11-24 |
| 1457637423 | Mary A Raven | Pharmacist | 2000 Bunker Lake Blvd Nw, T2025, Andover, MN 55304-4014 | 2011-10-22 |
| 1710273271 | Courtney Jo Smith | Pharmacist | 2000 Bunker Lake Blvd Nw, Andover, MN 55304-4014 | 2011-06-23 |
| 1467748970 | Sandra Lynn Posten | Pharmacist | 2000 Bunker Lake Blvd Nw, T-2025, Andover, MN 55304-4014 | 2011-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114402211 | Sarah Sue Anderson | Speech-Language Pathologist | 1891 Station Pkwy, Andover, MN 55304 | 2018-09-25 |
| 1306354329 | Jennifer Lynn Larkey I | Counselor | 1875 Station Parkway N.w. Andover, Mn 55304, Andover, MN 55304 | 2018-01-11 |
| 1124544895 | Msp Dentistry Inc | Preferred Provider Organization | 13650 Hanson Blvd., Suite #110, Andover, MN 55304 | 2017-08-15 |
| 1912427931 | Brooke Nicole Halliday | Counselor | 1875 Station Pkwy Ne, Andover, MN 55304 | 2017-06-21 |
| 1700286903 | Jari Welle, Inc. | Marriage & Family Therapist | 1328 Mckay Drive Ne, Suite 100, Ham Lake, MN 55304 | 2014-08-26 |
| 1356765192 | Cherrywood Advanced Living, LLC | Assisted Living Facility | 1889 139th Ave Nw, Andover, MN 55304 | 2014-02-14 |
| 1326462177 | Cherrywood Advanced Living, LLC | Assisted Living Facility | 1899 139th Ave Nw, Andover, MN 55304 | 2014-02-14 |
| 1740619568 | Delores Weikle | Physical Therapist | 14531 Jay St, Andover, MN 55304 | 2013-11-02 |
| 1730527003 | Darkou Care Services | Home Health | 14297 Zilla Street Nw, Andover, MN 55304 | 2013-06-10 |
| 1770927758 | Arbor Oaks Senior Living | Assisted Living Facility | 1640 155th Lane Nw, Andover, MN 55304 | 2013-04-22 |
| Find all providers in zip 55304 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801966866 | Statton Inc. | Pharmacy | 270 East Main St., Andover, OH 44003-1087 | 2006-11-08 |
| 1265486682 | Letourneau's Pharmacy, Inc. | Pharmacy | 349 N Main St, Andover, MA 01810-2687 | 2006-05-20 |
| 1619089612 | Goodrich Pharmacy Inc | Pharmacy | 15245 Bluebird St Nw, Andover, MN 55304-3538 | 2006-08-31 |
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| 1740711753 | Hennepin Healthcare System Inc | Pharmacy | 800 Washington Ave N Ste 190, Minneapolis, MN 55401-1330 | 2017-03-22 |
| 1568903532 | First Choice Pharmacy of Jordan PC | Pharmacy | 165 West Commerce Drive, Suite 110, Belle Plaine, MN 56011 | 2017-03-10 |
| 1013454545 | Genesis Recovery Services, LLC | Pharmacy | 5 N 3rd Ave W Ste 302, Duluth, MN 55802-1614 | 2017-01-23 |
| 1104360973 | Group Health Plan, Inc. | Pharmacy | 3800 Park Nicollet Blvd Ste 1170, St Louis Park, MN 55416-2527 | 2016-12-13 |
| 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.