GRAND ST PAUL CVS L L C (NPI# 1700180692) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700180692 |
| Entity Type | Organization |
| Organization Name | GRAND ST PAUL CVS L L C |
| Other Organization Name | CVS PHARMACY # 03054 |
| Practice Address |
1175 Madison Ave Mankato MN 56001-5227 |
| Mailing Address |
1 Cvs Dr Woonsocket RI 02895-6146 |
| Practice Telephone | 5076251791 |
| Practice Fax Number | 4017707108 |
| Mailing Telephone | 4017651500 |
| Mailing Fax Number | 4017707108 |
| Enumeration Date | 2011-01-06 |
| Last Update Date | 2011-04-20 |
| Authorized Official Name | SUSAN F. COLBERT (DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017651500 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | NCPDP | 2430534 | 01 |
| MN | 1700180692 | 05 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy # 03054 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487131330 | Grand St Paul Cvs L L C | Durable Medical Equipment & Medical Supplies | 4400 Oak Grove Parkway, Brooklyn Park, MN 55443 | 2018-07-24 |
| 1952825051 | Grand St Paul Cvs L L C | Durable Medical Equipment & Medical Supplies | 1300 West Lake St, Minneapolis, MN 55408-2763 | 2017-07-31 |
| 1578821245 | Grand St Paul Cvs L L C | Durable Medical Equipment & Medical Supplies | 880 Washington Ave Se, Minneapolis, MN 55414-3035 | 2012-05-01 |
| Street Address |
1175 MADISON AVE |
| City | MANKATO |
| State | MN |
| Zip Code | 56001-5227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013538818 | Kenneth Patrick Buckley | Pharmacist | 1175 Madison Ave, Mankato, MN 56001-5227 | 2020-05-03 |
| 1689203358 | Ricky Alan Hurd | Pharmacist | 1175 Madison Ave, Mankato, MN 56001-5227 | 2020-04-05 |
| 1619504594 | Gregory B Amundson | Pharmacist | 1175 Madison Ave, Mankato, MN 56001-5227 | 2020-03-23 |
| 1629604020 | Shawn Cowell | Pharmacist | 1175 Madison Ave, Mankato, MN 56001-5227 | 2020-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| 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 |
|---|---|---|---|---|
| 1417041815 | Snyders Drug | Pharmacy | 602 S Front St, Mankato, MN 56001-3801 | 2006-10-03 |
| 1598282303 | Thrifty Drug Stores Inc | Pharmacy | 1703 Madison Ave, Mankato, MN 56001-5447 | 2017-08-23 |
| 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 | ||||
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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.