GRAND ST PAUL CVS LLC (NPI# 1770770828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770770828 |
Entity Type | Organization |
Organization Name | GRAND ST PAUL CVS LLC |
Other Organization Name | CVS PHARMACY # 00241 |
Practice Address |
19605 Pilot Knob Rd. Farmington MN 55024 |
Mailing Address |
1 Cvs Dr Box 1075 - Pharmacy Enrollments Woonsocket RI 02895-6146 |
Practice Telephone | 6514633693 |
Mailing Telephone | 4017651500 |
Mailing Fax Number | 4017707108 |
Enumeration Date | 2007-10-02 |
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 | 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 | COMMERCIAL NUMBER | 2428488 | 01 |
MN | 529160100 | 05 |
Other Name | Type Code |
---|---|
CVS Pharmacy # 00241 | 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 |
19605 PILOT KNOB RD. |
City | FARMINGTON |
State | MN |
Zip Code | 55024 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932758158 | Renetia Jackson | Technician | 1210 Spruce Street, Farmington, MN 55024 | 2019-09-10 |
1871094912 | Megan Provost | Registered Nurse | 17680 Formosa Ave, Farmington, MN 55024 | 2018-02-23 |
1356752463 | Your Vision Achieved, LLC | Marriage & Family Therapist | 5404 187th Street West, Farmington, MN 55024 | 2014-05-12 |
1427304203 | Joseph Samuel Emond Jr. | Family Medicine | 19730 Meadowlark Way, Farmington, MN 55024 | 2012-07-30 |
1053680991 | Annie Lee Mickelson | Chiropractor | 20700 Chippendale Ave Suite 7, Farmington, MN 55024 | 2011-12-21 |
1275725277 | Family Vision Clinic of Farmington | Optometrist | 19650 Pilot Knob Road, Farmington, MN 55024 | 2007-08-14 |
1871503136 | Independent School District #192 | Early Intervention Provider Agency | 20655 Flagstaff Avenue, Farmington, MN 55024 | 2006-08-09 |
1588692669 | Northfield Hospital | Clinic/Center | 4645 Knutsen Dr, Farmington, MN 55024 | 2006-06-29 |
1902887284 | David E Truax | Chiropractor | 20700 Chippendale Ave, Suite 7, Farmington, MN 55024 | 2005-11-14 |
1114277670 | Luanne Kuelbs | Home Health | 405 8th Street, Farmington, MN 55024 | 2012-09-12 |
Find all providers in zip 55024 |
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] |
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1629131248 | Millers Pharmacy of Farmington | Pharmacy | 6181 Route 96, Farmington, NY 14425-1004 | 2006-12-18 |
1619043379 | Town & Country Grocers of Fredericktown Mo Inc | Pharmacy | 125 W Karsch Blvd, Farmington, MO 63640-2156 | 2006-11-27 |
1053338939 | Tayler Health LLC | Pharmacy | 32316 Grand River Ave, Farmington, MI 48336-3201 | 2006-07-16 |
1851316483 | Smiths Food & Drug Centers Inc | Pharmacy | 1316 N Highway 89, Farmington, UT 84025-3841 | 2006-07-13 |
1386669935 | Bormans Inc | Pharmacy | 22128 Farmington Rd, Farmington, MI 48336-4010 | 2006-07-13 |
1275564254 | Kmart of Michigan Inc | Pharmacy | 37175 Grand River Ave, Farmington, MI 48335-2821 | 2006-07-06 |
1649772351 | Med-mart Pharmacy LLC | Pharmacy | 100 Main Street, Farmington, WV 26571 | 2018-03-08 |
1720492564 | Walmart Inc. | Pharmacy | 367 W Main St, Farmington, AR 72730-2622 | 2014-06-19 |
Find all providers in FARMINGTON |
City | FARMINGTON |
Zip Code | 55024 |
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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.