GRAND ST PAUL CVS LLC (NPI# 1609975911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609975911 |
| Entity Type | Organization |
| Organization Name | GRAND ST PAUL CVS LLC |
| Other Organization Name | CVS PHARMACY #01746 |
| Practice Address |
2150 Eagle Creek Ln Woodbury MN 55129-3201 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 6514364732 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2010-11-18 |
| 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 | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | 2626657 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2427068 | 01 | |
| MN | 010602000 | 05 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #01746 | 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 |
2150 EAGLE CREEK LN |
| City | WOODBURY |
| State | MN |
| Zip Code | 55129-3201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689668303 | Jodi Lyn Baumgartner | Physician Assistant | 2150 Eagle Creek Ln, Woodbury, MN 55129-3201 | 2005-09-08 |
| 1477175818 | Kari French | Pharmacist | 2150 Eagle Creek Ln, Woodbury, MN 55129-3201 | 2020-05-07 |
| 1902431414 | Nathan Alpert | Pharmacist | 2150 Eagle Creek Ln, Woodbury, MN 55129-3201 | 2020-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770006983 | Logan Thompson | Chiropractor | 10631 Pond Curve, Woodbury, MN 55129 | 2017-07-19 |
| 1942650619 | The Hendricks Group Inc. | Assisted Living Facility | 10025 Antrim Court, Woodbury, MN 55129 | 2016-06-14 |
| 1235588468 | Nathan Robert Mayernik | Physical Therapist | 4123 Radio Dr, Suite 100, Woodbury, MN 55129 | 2016-06-08 |
| 1699146035 | St. Therese of Woodbury, LLC | Skilled Nursing Facility | 7555 Bailey Road, Woodbury, MN 55129 | 2015-10-12 |
| 1548602865 | Monica Bajracharya | Internal Medicine | 9373 Compass Pointe Rd, Woodbury, MN 55129 | 2013-07-28 |
| 1730454752 | Amanda E Feeney | Physical Therapist | 4123 Radio Drive, Ste 100, Woodbury, MN 55129 | 2012-03-09 |
| 1104193762 | Minneapolis-st.paul Endodontics | Dentist | 10150 City Walk Dr Ste C, Woodbury, MN 55129 | 2011-11-28 |
| 1659502417 | Charles Goff Jr. | Marriage & Family Therapist | 1919 University Ave W Suite 200, St. Paul, MN 55129 | 2009-07-28 |
| 1497821391 | Kyle Riley Edlund | Dentist | 3060 Woodbury Drive, #b, Woodbury, MN 55129 | 2006-11-24 |
| 1902979206 | Robert Edgar Eng | Dentist | 3100 Woodbury Drive, Woodbury, MN 55129 | 2006-11-16 |
| Find all providers in zip 55129 | ||||
| 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 |
|---|---|---|---|---|
| 1215092671 | Evergreen Pharmacy | Pharmacy | 118 E Red Bank Ave, Woodbury, NJ 08096-3559 | 2006-12-26 |
| 1033203435 | Snyders Bros Inc | Pharmacy | 1750 Weir Dr, Woodbury, MN 55125-2252 | 2006-10-03 |
| 1841305984 | Supervalu Pharmacies Inc | Pharmacy | 8432 Tamarack Vlg, Woodbury, MN 55125-3383 | 2006-08-20 |
| 1528085925 | Walmart Inc. | Pharmacy | 10240 Hudson Rd, Woodbury, MN 55129-9111 | 2006-07-16 |
| 1811964190 | Woodson's Pharmacy, Inc. | Pharmacy | 304 W Main St, Woodbury, TN 37190-1125 | 2006-03-04 |
| 1437677796 | Woodbury Drug Center LLC | Pharmacy | 604 W Main St, Woodbury, TN 37190-1029 | 2017-09-06 |
| 1316267958 | N H Raahil LLC | Pharmacy | 160 N Broad St, Woodbury, NJ 08096-1720 | 2010-06-06 |
| 1609921253 | Cottage Pharmacy & Surgical Inc | Pharmacy | 8285 Jericho Tpke, Woodbury, NY 11797-1807 | 2007-01-24 |
| 1942305800 | Upr Care Corp | Pharmacy | 378 Syosset Woodbury Rd, Woodbury, NY 11797-1200 | 2006-09-14 |
| 1073545000 | Freds Stores of Tennessee Inc | Pharmacy | 1130 S Mccrary St, Woodbury, TN 37190-5997 | 2006-07-07 |
| Find all providers in WOODBURY | ||||
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.