SUPERVALU PHARMACIES INC


Address: 1020 Diffley Rd, Eagan, MN 55123-1777
Phone: 6514525500

SUPERVALU PHARMACIES INC (NPI# 1598912560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1598912560
Entity Type Organization
Organization Name SUPERVALU PHARMACIES INC
Other Organization Name CUB PHARMACY
Practice Address 1020 Diffley Rd
Eagan
MN 55123-1777
Mailing Address 11840 Valley View Rd
Attn: Managed Care Pharmacy Dept.
Eden Prairie
MN 55344-3643
Practice Telephone 6514525500
Practice Fax Number 6514523102
Mailing Telephone 9528284588
Mailing Fax Number 9529473470
Enumeration Date 2008-08-21
Last Update Date 2016-10-03
Authorized Official Name AARON SAPP (DIRECTOR OF PHARMACY SERVICES)
Authorized Official Telephone 9528284026
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 332B00000X Durable Medical Equipment & Medical Supplies Suppliers
Y 3336C0003X Pharmacy
Specialization: Community/Retail Pharmacy
263255 MN Suppliers

Other Provider Identifier

State Issuer Identifier Type Code
PK 2117429 01
MN 035477000 05

Other Provider/Organization Names

Other Name Type Code
CUB PHARMACY Doing Business As Name - Organization

Other Provider IDs and Locations

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
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

Other Data Sources

Entity Type Entity Name Entity Address
Virginia Business Entities SUPERVALU Pharmacies Inc. 11840 Valley View Rd, Eden Prairie, Minnesota 55344

Office Location

Street Address 1020 DIFFLEY RD
City EAGAN
State MN
Zip Code 55123-1777

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1053828467 Hilltop Family Chiropractic Center Pa Chiropractor 1121 Town Centre Drive Suite 202, Eagan, MN 55123 2018-01-08
1922452507 Jacob Zimmerman Counselor 3450 O'leary Ln., Eagan, MN 55123 2016-04-20
1316320971 K-squared Fitness, L.L.C. Public Health or Welfare 1100 Cliff Rd, Eagan, MN 55123 2015-07-01
1346683687 Joshua M Dorn Allergy & Immunology 3460 Promenade Ave, Eagan, MN 55123 2013-04-16
1700172350 Mary Christine Mcnabney Nurse Practitioner 610 Opperman Drive, D4 Health Center, Your Wellbeing Health Center, Eagan, MN 55123 2011-06-22
1033353669 Todd Borstad Social Worker 3450 O'leary Lane, Eagan, MN 55123 2009-04-27
1821025271 Mngi Endoscopy LLC Clinic/Center 1185 Town Centre Drive, Eagan, MN 55123 2006-06-28
1780620120 Cindy Eileen Wood Audiologist 3440 Oleary Lane, 240, Eagan, MN 55123 2006-06-22
1609845742 Jeffery R Dichter Internal Medicine 849 Govern Circle, Saint Paul, MN 55123 2006-03-14
1891269155 Elise Broderick Quam Social Worker 3450 Oleary Ln, Eagan, MN 55123 2019-01-18
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Taxonomy Information

Taxonomy Code 3336C0003X
Grouping Suppliers
Classification Pharmacy
Specialization Community/Retail Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1467908699 Hy Vee Inc Pharmacy 1500 Central Park Commons Drive, Eagan, MN 55121 2016-08-28
1033458922 Minnesota Independent Cooperative Pharmacy 2980 Commers Dr Ste 200, Eagan, MN 55121-2370 2013-02-12
1043310485 Grand St Paul Cvs LLC Pharmacy 4241 Jonny Cake Rd, Eagan, MN 55122 2006-09-25
1588679807 Walgreen Co Pharmacy 2010 Cliff Rd, Eagan, MN 55122-2313 2006-07-29
1225050909 Grand St Paul Cvs LLC Pharmacy 2000 Cliff Lake Rd, Eagan, MN 55122-2400 2006-07-24
1831749126 Costco Wholesale Corporation Pharmacy 995 Blue Gentian Rd, Eagan, MN 55121-1542 2019-09-18
1295146702 Supervalu Pharmacies Inc Pharmacy 1276 Town Centre Dr, Eagan, MN 55123-1064 2014-05-19

Providers in the same taxonomy and state

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
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Competitor

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City EAGAN
Zip Code 55123

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Dataset Information

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.

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