GRAND ST PAUL CVS LLC (NPI# 1699079483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1699079483 |
Entity Type | Organization |
Organization Name | GRAND ST PAUL CVS LLC |
Other Organization Name | CVS PHARMACY #17466 |
Practice Address |
449 Commerce Dr Woodbury MN 55125-4872 |
Mailing Address |
1 Cvs Dr Mail Code 1090 Woonsocket RI 02895-6146 |
Practice Telephone | 6512391875 |
Practice Fax Number | 6512391885 |
Mailing Telephone | 4017651500 |
Enumeration Date | 2011-01-07 |
Last Update Date | 2016-11-21 |
Authorized Official Name | SUSAN COLBERT (SR. 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 |
263655 | MN | Suppliers |
Y | 333600000X | Pharmacy | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PK | 2128270 | 01 | |
MN | 1699079483 | 05 |
Other Name | Type Code |
---|---|
CVS Pharmacy #17466 | 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 |
449 COMMERCE DR |
City | WOODBURY |
State | MN |
Zip Code | 55125-4872 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871789123 | Alissa Paul | Physician Assistant | 449 Commerce Dr, Woodbury, MN 55125-4872 | 2007-09-20 |
1043847098 | Kelsey Krause | Pharmacist | 449 Commerce Dr, Woodbury, MN 55125-4872 | 2020-03-26 |
1194350595 | Amy Kukacka | Pharmacist | 449 Commerce Dr, Woodbury, MN 55125-4872 | 2020-03-05 |
1528495397 | Brenda Deutsch | Nurse Practitioner | 449 Commerce Dr, Woodbury, MN 55125-4872 | 2013-10-10 |
1437582301 | Aretha Baidoo | Pharmacist | 449 Commerce Dr, Woodbury, MN 55125-4872 | 2013-08-15 |
1518254465 | Erinne Hess | Pharmacist | 449 Commerce Dr, Woodbury, MN 55125-4872 | 2011-06-29 |
1013203264 | Melissa N Nord | Pharmacist | 449 Commerce Dr, T2406, Woodbury, MN 55125-4872 | 2011-06-27 |
1992090534 | Traci Diane Robinson | Pharmacist | 449 Commerce Dr, T-2406, Woodbury, MN 55125-4872 | 2011-06-11 |
1871890905 | Luxottica Retail North America Inc | Eyewear Supplier (Equipment, not the service) | 449 Commerce Dr, Woodbury, MN 55125-4872 | 2011-02-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487268728 | Haley Kirkpatrick | Behavior Technician | 721 Commerce Dr., Woodbury, MN 55125 | 2020-09-03 |
1689218091 | Jordan Schmidt | Student in an Organized Health Care Education/Training Program | 1740 Welr Dr. #24, Woodbury, MN 55125 | 2019-10-30 |
1629619580 | Mackenzie Ann Funke | Occupational Therapist | 721 Commerce Drivve, Woodbury, MN 55125 | 2019-10-02 |
1700342029 | Darcy Stivland | Counselor | 1811 Weir Drive #270, Woodbury, MN 55125 | 2019-02-11 |
1235609884 | Elizabeth Kennedy Ward | Psychologist | 7582 Currell Blvd Suite 208, Woodbury, MN 55125 | 2018-11-27 |
1528573664 | Cory Lee Baumeister | Counselor | 652 Bielenberg Dr, Woodbury, MN 55125 | 2017-12-12 |
1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
1366988826 | Mark Your Home Health Care LLC | Home Health | 6053 Hudson Road, Suite 200, Woodbury, MN 55125 | 2017-01-09 |
1518415736 | Kubei Holdings Group LLC | Case Management | 6043 Hudson Rd Ste 340, Saint Paul, MN 55125 | 2016-09-16 |
1285087072 | Adrian Jung | Occupational Therapist | 155 Radio Drive, Woodbury, MN 55125 | 2016-07-18 |
Find all providers in zip 55125 |
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 |
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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.