SUPERVALU PHARMACIES INC (NPI# 1336397298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336397298 |
| Entity Type | Organization |
| Organization Name | SUPERVALU PHARMACIES INC |
| Other Organization Name | CUB PHARMACY |
| Practice Address |
1177 Clarence St Saint Paul MN 55106-2809 |
| Mailing Address |
11840 Valley View Rd Attn: Managed Care Pharmacy Dept. Eden Prairie MN 55344-3643 |
| Practice Telephone | 6517747772 |
| Practice Fax Number | 6517747799 |
| Mailing Telephone | 9528284588 |
| Mailing Fax Number | 9529473470 |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2017-02-20 |
| Authorized Official Name | JESSICA O'CONNELL (MANGER, MANAGED CARE) |
| Authorized Official Telephone | 9528284588 |
| 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 |
263254 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2116850 | 01 | |
| MN | 851930000 | 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 |
| 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 |
1177 CLARENCE ST |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55106-2809 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720692403 | Shoua Yang | Pharmacist | 1180 Arcade St., St. Paul, MN 55106 | 2020-09-01 |
| 1477196715 | The Doctors Medical Clinic, P.a. | Family Medicine | 1504 Whitebear Ave, St Paul, MN 55106 | 2019-10-18 |
| 1144870544 | Lucy Anne Claugherty | Technician | 975 Cook Ave E., St. Paul, MN 55106 | 2019-09-17 |
| 1326602756 | Leslie Neher | Student in an Organized Health Care Education/Training Program | 1414 Maryland Avenue East, St. Paul, MN 55106 | 2019-05-01 |
| 1841758851 | Susan Janine Ferrell | Dental Hygienist | East Side Dental, 895 East 7th Street, St Paul, MN 55106 | 2019-03-08 |
| 1811465271 | Care Plus Hha Inc | Home Health | 1299 Arcade Street, Ste 100, St. Paul, MN 55106 | 2018-11-05 |
| 1033696760 | Strong Tower Health | Clinical Nurse Specialist | 1686 Suburban Ave, St Paul, MN 55106 | 2018-07-25 |
| 1861978439 | William Warmka | Physical Therapist | 1385 Phalen Blvd, St. Paul, MN 55106 | 2018-07-17 |
| 1902392111 | Chaffee Dialysis LLC | Clinic/Center | 862 Arcade St, Saint Paul, MN 55106 | 2018-07-11 |
| 1922594217 | Vangneng Xiong | Marriage & Family Therapist | 1299 Arcade St Ste 202, Saint Paul, MN 55106 | 2018-07-10 |
| Find all providers in zip 55106 | ||||
| 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 |
|---|---|---|---|---|
| 1205460169 | Genoa Healthcare, LLC | Pharmacy | 1515 Energy Park Dr Ste 110, Saint Paul, MN 55108-5229 | 2020-02-28 |
| 1194127985 | Como Pharmacy Inc | Pharmacy | 217 Como Ave Ste 107, Saint Paul, MN 55103-1838 | 2014-09-23 |
| 1043599590 | Allina Health System | Pharmacy | 333 Smith Ave N # 1793, Saint Paul, MN 55102-2344 | 2011-08-15 |
| 1972892438 | Phalen Family Pharmacy Ltd | Pharmacy | 1001 Johnson Pkwy Ste B23, Saint Paul, MN 55106-3474 | 2011-04-05 |
| 1821253246 | Carecenter Pharmacy LLC | Pharmacy | 3m Center Bldg 2221n1, Saint Paul, MN 55144-1001 | 2008-07-24 |
| 1336248632 | Grand St Paul Cvs LLC | Pharmacy | 810 Maryland Ave E, Saint Paul, MN 55106-2511 | 2006-09-22 |
| 1497760714 | Walgreen Co | Pharmacy | 734 Grand Ave, Saint Paul, MN 55105-3421 | 2006-07-29 |
| 1689689903 | Walgreen Co | Pharmacy | 1585 Randolph Ave, Saint Paul, MN 55105-2149 | 2006-07-29 |
| 1396750527 | Walgreen Co | Pharmacy | 1788 Old Hudson Rd, Saint Paul, MN 55119-4307 | 2006-07-29 |
| 1235144544 | Walgreen Co | Pharmacy | 1401 Maryland Ave E, Saint Paul, MN 55106-2823 | 2006-07-29 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55106 |
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.