SUPERVALU PHARMACIES INC (NPI# 1235681958) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235681958 |
| Entity Type | Organization |
| Organization Name | SUPERVALU PHARMACIES INC |
| Other Organization Name | CUB PHARMACY 1592 |
| Practice Address |
10881 University Ave Ne Blaine MN 55434 |
| Mailing Address |
11840 Valley View Rd Eden Prairie MN 55344-3643 |
| Practice Telephone | 7637678271 |
| Practice Fax Number | 7637720871 |
| Mailing Telephone | 9528284588 |
| Mailing Fax Number | 9529473470 |
| Enumeration Date | 2016-10-28 |
| 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 |
265185 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE NSC | 0326790251 | 01 | |
| PK | 2164696 | 01 | |
| NCPDP | 2433338 | 01 |
| Other Name | Type Code |
|---|---|
| CUB Pharmacy 1592 | 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 |
| 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 |
| 1265628515 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 20250 Heritage Dr, Lakeville, MN 55044-6869 | 2007-09-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | SUPERVALU Pharmacies Inc. | 11840 Valley View Rd, Eden Prairie, Minnesota 55344 |
| Street Address |
10881 UNIVERSITY AVE NE |
| City | BLAINE |
| State | MN |
| Zip Code | 55434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003317728 | Sarah Marie Kunkel | Pharmacist | 10881 University Ave Ne, Blaine, MN 55434-8032 | 2018-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023628591 | Rahul Farmah | Optometrist | 680 Hwy 10 Ne, Blaine, MN 55434 | 2020-08-08 |
| 1033770714 | Enduring Home Health Care Corp | Home Health | 10812 Fillmore Street, Blaine, MN 55434 | 2019-06-24 |
| 1932762408 | Vital Agency LLC | In Home Supportive Care | 12864 Fillmore Street Ne, Blaine, MN 55434 | 2019-04-19 |
| 1548751654 | Dustin Adam Kakach | Pharmacist | 600 County Hwy 10, Blaine, MN 55434 | 2018-05-24 |
| 1598253445 | Jacob James Apland | Behavioral Analyst | 12401 Oak Park Blvd Ne Apt 316, Blaine, MN 55434 | 2018-04-26 |
| 1962921924 | Mw Minnetonka Operating LLC | Assisted Living Facility | 1005 Paul Parkway Ne, Blaine, MN 55434 | 2017-09-11 |
| 1922526961 | Blaine Asc, LLC | Clinic/Center | 11225 Ulysses Street Northeast, Blaine, MN 55434 | 2017-08-30 |
| 1629591334 | Minnehaha Transportation Inc | Non-emergency Medical Transport (VAN) | 2507 Walnut St, Roseville, MN 55434 | 2017-07-25 |
| 1629590872 | Alexandra Staum Reif | Pediatrics | 11107 Ulysses Street Ne, Suite 100, Blaine, MN 55434 | 2017-07-10 |
| 1962939546 | Nicolette Gengel | Dentist | 1384 109th Ave Ne Ste 200, Blaine, MN 55434 | 2017-05-15 |
| Find all providers in zip 55434 | ||||
| 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 |
|---|---|---|---|---|
| 1932115573 | Walgreen Co | Pharmacy | 12480 Aberdeen St Ne, Blaine, MN 55449-4721 | 2006-08-01 |
| 1245339548 | Grand St Paul Cvs LLC | Pharmacy | 2357 108th Ln Ne, Blaine, MN 55449-5222 | 2006-09-22 |
| 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.