SUPERVALU PHARMACIES INC (NPI# 1215348727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215348727 |
| Entity Type | Organization |
| Organization Name | SUPERVALU PHARMACIES INC |
| Other Organization Name | CUB PHARMACY |
| Practice Address |
17756 Kenwood Trl Lakeville MN 55044 |
| Mailing Address |
11840 Valley View Rd Eden Prairie MN 55344-3643 |
| Practice Telephone | 9524350542 |
| Practice Fax Number | 9524352072 |
| Mailing Telephone | 9528284588 |
| Mailing Fax Number | 9529473470 |
| Enumeration Date | 2014-05-19 |
| 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 |
264452 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1215348727 | 05 | |
| PK | 2146380 | 01 | |
| NCPDP | 2432449 | 01 |
| 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 |
17756 KENWOOD TRL |
| City | LAKEVILLE |
| State | MN |
| Zip Code | 55044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275681538 | Rbf LLC | Pharmacy | 17756 Kenwood Trl, Lakeville, MN 55044-9454 | 2007-01-05 |
| 1790191260 | Yousif Murad | Pharmacist | 17756 Kenwood Trl, Lakeville, MN 55044-9454 | 2014-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518528397 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | Fairview Lakeville Clinic Mtm, 18580 Joplin Ave, Lakeville, MN 55044 | 2019-06-24 |
| 1164922373 | Invigorate Chiropractic, Pa | Chiropractor | 18449 Orchard Trail, Lakeville, MN 55044 | 2018-02-14 |
| 1275046344 | Kevin Schultz | Chiropractor | 18449 Orchard Tr, Lakeville, MN 55044 | 2017-11-13 |
| 1518487263 | Katarina Klementina Foster | Dentist | 16138 Pilot Knob Rd, Lakeville, MN 55044 | 2017-06-23 |
| 1275069676 | Alison Marie Weaver | Physical Therapist | 17599 Kenwood Trl Ste 200, Lakeville, MN 55044 | 2017-05-04 |
| 1184177479 | Megan Erickson | Physical Therapist | 21034 Heron Way Ste 102, Lakeville, MN 55044 | 2016-08-03 |
| 1669827523 | Kristine Louise Duhamel | Nurse Practitioner | 18275 Kenrick Avenue, Lakeville, MN 55044 | 2016-04-28 |
| 1003281536 | Heather Leann Wegner | Counselor | 16233 Kenyon Ave, Lakeville, MN 55044 | 2015-12-09 |
| 1982081295 | Dana Bungert | Specialist/Technologist | 11060 Upper 167th St W, Lakeville, MN 55044 | 2015-05-06 |
| 1265834931 | Kayla Schulz | Counselor | 7535 165th St West, Lakeville, MN 55044 | 2014-09-24 |
| Find all providers in zip 55044 | ||||
| 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 |
|---|---|---|---|---|
| 1487748760 | Grand St Paul Cvs Phcy LLC | Pharmacy | 17578 Dood Blvd, Lakeville, MN 55044 | 2006-10-03 |
| 1538789771 | Sharon Le | Pharmacy | 17578 Dodd Blvd, Lakeville, MN 55044-3909 | 2020-04-17 |
| 1851746986 | Hy Vee Inc | Pharmacy | 16150 Pilot Knob Rd, Lakeville, MN 55044-4105 | 2016-04-26 |
| 1306057179 | Walgreen Co | Pharmacy | 32 Main St, Lakeville, MA 02347-1607 | 2007-05-24 |
| 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.