GRAND ST PAUL CVS LLC (NPI# 1558566166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558566166 |
| Entity Type | Organization |
| Organization Name | GRAND ST PAUL CVS LLC |
| Other Organization Name | CVS PHARMACY # 04696 |
| Practice Address |
21455 John Milless Drive Rogers MN 55374 |
| Mailing Address |
1 Cvs Dr Box 1075 - Pharmacy Enrollments Woonsocket RI 02895-6146 |
| Practice Telephone | 7634282629 |
| Mailing Telephone | 4017651500 |
| Mailing Fax Number | 4017707108 |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2011-10-25 |
| Authorized Official Name | SUSAN COLBERT (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 |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy # 04696 | 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 |
21455 JOHN MILLESS DRIVE |
| City | ROGERS |
| State | MN |
| Zip Code | 55374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609335835 | Rebecca Loehrer | Nurse Practitioner | 21370 Ste 210 John Milless Dr., Rogers, MN 55374 | 2019-03-18 |
| 1255722328 | Samantha Colai | Marriage & Family Therapist | 21307 John Milless Drive, Suite 106, Rogers, MN 55374 | 2015-02-11 |
| 1437559648 | Jamie Mosley | Counselor | 2100 Rogers Drive, Suite 200, Rogers, MN 55374 | 2014-08-26 |
| 1295145886 | Marisa Kolasa | Massage Therapist | 22290 Oakdale Drive, Rogers, MN 55374 | 2014-05-05 |
| 1871878165 | Derek P Doty Dc Inc | Chiropractor | 21410 136th Ave N, Suite 105a, Rogers, MN 55374 | 2011-10-18 |
| 1912205865 | Michelle Cheryl Finnegan-larson | Registered Nurse | 21308 John Milless Drive, Rogers, MN 55374 | 2011-03-02 |
| 1639402571 | Ascend Family Institute | Community/Behavioral Health | 20980 Rogers Drive, #400, Rogers, MN 55374 | 2009-09-10 |
| 1275738403 | Nicole M Clements | Physician Assistant | 1355 Rogers Drive, Rogers, MN 55374 | 2007-06-18 |
| 1811062854 | Randall Alvin Hohbein | Pharmacist | 21351 John Milless Drive, Rogers Drug, Rogers, MN 55374 | 2006-11-22 |
| 1710058128 | Jeffrey Alan Smith | Dentist | 21410 136th Ave North Suite #109, Rogers, MN 55374 | 2006-11-10 |
| Find all providers in zip 55374 | ||||
| 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 |
|---|---|---|---|---|
| 1821475195 | Walmart Inc. | Pharmacy | 808 W Walnut St, Rogers, AR 72756-3538 | 2015-05-06 |
| 1487747127 | Pharmacy Operations, Inc. | Pharmacy | 1300 West Walnut, Rogers, AR 72756 | 2006-10-02 |
| 1144320466 | Harps Food Stores, Inc | Pharmacy | 103 N Dixieland Rd, Rogers, AR 72756-3203 | 2006-09-25 |
| 1477556926 | Debbies Family Pharmacy Inc | Pharmacy | 5403 W Pinnacle Pointe Dr, Rogers, AR 72758-8118 | 2005-05-28 |
| 1225516701 | Malorie Moreland | Pharmacy | 2110 W Walnut St, Rogers, AR 72756-3246 | 2018-08-06 |
| 1487104725 | Debbie's Family Pharmacy, Inc. | Pharmacy | 5403 W Pinnacle Pointe Dr, Rogers, AR 72758-8118 | 2016-10-11 |
| 1467693754 | W P Malone Inc | Pharmacy | 216 S 13th St, Suite B, Rogers, AR 72758-4204 | 2009-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861033276 | Nina Marie Kleinschmidt | Pharmacy | 1315 Minnesota Ave, Detroit Lakes, MN 56501-3913 | 2019-10-07 |
| 1659837698 | Bpoint Pharmacy Services Ltd | Pharmacy | 30833 North Star Dr, Suite 2, Breezy Point, MN 56472 | 2019-02-14 |
| 1477042372 | Sanford Clinic North | Pharmacy | 1611 Anne St Nw Ste 1, Bemidji, MN 56601-5114 | 2018-05-07 |
| 1295222909 | A & E Pharmacy LLC | Pharmacy | 1509 10th Ave S, Minneapolis, MN 55404-1754 | 2018-04-18 |
| 1215445085 | Genoa Healthcare LLC | Pharmacy | 8441 Wayzata Blvd, Suite 340, Golden Valley, MN 55426-1372 | 2018-01-16 |
| 1497279608 | Coborns Inc | Pharmacy | 110 1st St S Ste B, Sauk Rapids, MN 56379-1404 | 2017-07-29 |
| 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 | ||||
Please comment or provide details below to improve the information on GRAND ST PAUL CVS LLC.
| 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.