SUPERVALU PHARMACIES INC (NPI# 1306951447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306951447 |
| Entity Type | Organization |
| Organization Name | SUPERVALU PHARMACIES INC |
| Other Organization Name | CUB PHARMACY |
| Practice Address |
12900 Riverdale Dr Nw Coon Rapids MN 55448-1282 |
| Mailing Address |
11840 Valley View Rd Attn: Managed Care Pharmacy Dept. Eden Prairie MN 55344-3643 |
| Practice Telephone | 7634210065 |
| Practice Fax Number | 7634215908 |
| Mailing Telephone | 9528284588 |
| Mailing Fax Number | 9529473470 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2016-10-03 |
| Authorized Official Name | AARON SAPP (DIRECTOR OF PHARMACY SERVICES) |
| Authorized Official Telephone | 9528284026 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
260728 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2046712 | 01 | |
| MN | 816360000 | 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 |
12900 RIVERDALE DR NW |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55448-1282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841285848 | Laurie Marha King | Nurse Practitioner | 12900 Riverdale Dr Nw, Coon Rapids, MN 55448-1063 | 2005-09-15 |
| 1841612538 | Jennifer Lach | Pharmacist | 12900 Riverdale Dr Nw, Coon Rapids, MN 55448-1282 | 2014-01-14 |
| 1144409764 | Janice Lynn Jensen | Pharmacist | 12900 Riverdale Dr Nw, Coon Rapids, MN 55448-1282 | 2007-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447741152 | Modern Sisters Home Healthcare | Home Health | 1852 131st Ln Nw, Coon Rapids, MN 55448 | 2018-05-29 |
| 1003345463 | Sarah Benepe | Occupational Therapy Assistant | 764 107th Ln Nw, Coon Rapids, MN 55448 | 2017-06-08 |
| 1700310299 | Orthodontics Specialist of Minnesota P.l.l.c. | Dentist | 3360 Northdale Blvd Nw, Coon Rapids, MN 55448 | 2017-04-12 |
| 1528459906 | Shane R Fisher | Registered Nurse | 10077 Dogwood St. Nw, Suite 110, Minneapolis, MN 55448 | 2015-02-06 |
| 1912395419 | Mn Dentistry, PC | Dentist | 3570 River Rapids Drive Nw, Ste 110, Coor Rapids, MN 55448 | 2015-01-06 |
| 1215297536 | Daniel Beau Ryan Ellis | Chiropractor | 9 125 Lane Nw, Coon Rapids, MN 55448 | 2012-05-21 |
| 1306142344 | At Home Health Care Inc. | Home Health | 1601 128th Lane Nw, Coon Rapids, MN 55448 | 2011-02-09 |
| 1245428317 | Cassandra Joice Carney | Massage Therapist | 8770 Springbrook Dr Nw, Coon Rapids, MN 55448 | 2007-10-14 |
| 1982826434 | Merry Heart Home Care Inc | Home Health | 3248 131st Avenue Nw, Coon Rapids, MN 55448 | 2007-05-03 |
| 1659416196 | James T Sturm | Emergency Medicine | 10160 Foley Blvd Nw Ste 120, Coon Rapids, MN 55448 | 2007-02-21 |
| Find all providers in zip 55448 | ||||
| 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 |
|---|---|---|---|---|
| 1770683112 | Grand St Paul Cvs LLC | Pharmacy | 10930 University Ave Nw, Coon Rapids, MN 55448-6120 | 2006-09-25 |
| 1932236130 | Ambor Corporation | Pharmacy | 9055 Springbrook Dr Nw, Coon Rapids, MN 55433-5841 | 2007-02-27 |
| 1518066810 | Grand St Paul Cvs LLC | Pharmacy | 2017 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-4121 | 2006-09-22 |
| 1568572188 | Costco Wholesale Corporation | Pharmacy | 12547 Riverdale Blvd Nw, Coon Rapids, MN 55448 | 2006-08-30 |
| 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 | ||||
| City | COON RAPIDS |
| Zip Code | 55448 |
Please comment or provide details below to improve the information on SUPERVALU PHARMACIES INC.
| 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.