SUPERVALU PHARMACIES INC (NPI# 1861507907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861507907 |
| Entity Type | Organization |
| Organization Name | SUPERVALU PHARMACIES INC |
| Other Organization Name | CUB PHARMACY |
| Practice Address |
8690 E Point Douglas Rd S Cottage Grove MN 55016 |
| Mailing Address |
11840 Valley View Rd Eden Prairie MN 55344-3643 |
| Practice Telephone | 6514597324 |
| Practice Fax Number | 6514598196 |
| Mailing Telephone | 9528284588 |
| Mailing Fax Number | 9529473470 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2018-06-20 |
| Authorized Official Name | STEVE MCCANN (VP PHARMACY) |
| Authorized Official Telephone | 9528284531 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
260354 | MN | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 455858800 | 05 | |
| PK | 2046445 | 01 | |
| NCPDP | 2417574 | 01 |
| Other Name | Type Code |
|---|---|
| CUB PHARMACY | Doing Business As Name - Organization |
| 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 |
| 1598912560 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 1020 Diffley Rd, Eagan, MN 55123-1777 | 2008-08-21 |
| 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 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | SUPERVALU Pharmacies Inc. | 11840 Valley View Rd, Eden Prairie, Minnesota 55344 |
| Street Address |
8690 E POINT DOUGLAS RD S |
| City | COTTAGE GROVE |
| State | MN |
| Zip Code | 55016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821307224 | Avanti Medical Group of Minnesota LLC | Clinic/Center | 8690 E Point Douglas Rd S, Cottage Grove, MN 55016-4007 | 2010-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073161519 | Kathleen Johnson | Technician | 7436 Hinton Park Ave South, Cottage Grove, MN 55016 | 2019-08-28 |
| 1710473434 | Cg Care Center, LLC. | Skilled Nursing Facility | 6993 80th Street South, Cottage Grove, MN 55016 | 2018-07-05 |
| 1235532771 | Lydia Sirucek | Nurse Practitioner | 8611 E Point Douglas Rd, Cottage Grove, MN 55016 | 2014-09-29 |
| 1366859746 | Home Care Service Providers Inc. | Home Health | 9635 Hamlet Ave, Cottage Grove, MN 55016 | 2014-07-17 |
| 1942622089 | Wal-mart Stores, Inc. | Technician/Technologist | 9300 East Point Douglas Rd S, Cottage Grove, MN 55016 | 2014-01-08 |
| 1255770962 | Southside At The Cottage Grove Site | Family Medicine | 8454 East Point Douglas Road, Cottage Grove, MN 55016 | 2013-06-17 |
| 1710222088 | Santori Chiropractic Center, LLC | Chiropractor | 7155 80th Street So, Cottage Grove, MN 55016 | 2012-11-28 |
| 1609151414 | Kenneth Nworah Okafor | Pharmacist | 7015 East Point Douglas Road, Cottage Grove, MN 55016 | 2011-10-13 |
| 1134432925 | Elizabeth Frances Rezek | Social Worker | 8813 Hale Ave S, Cottage Grove, MN 55016 | 2010-07-21 |
| 1841420882 | Mark Joseph Mangine | Physical Therapist | 6936 Pine Arbor Dr S Ste 150, Cottage Grove, MN 55016 | 2009-07-24 |
| Find all providers in zip 55016 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588131296 | Home Town Drugs of Cottage Grove, Inc. | Pharmacy | 1205 Hwy 99 North, Cottage Grove, OR 97424 | 2018-10-31 |
| 1437428653 | Md Group, LLC | Pharmacy | 536 Southing Grange, Unit G, Cottage Grove, WI 53527-9337 | 2011-12-16 |
| 1861414542 | Grand St Paul Cvs LLC | Pharmacy | 8655 E Point Douglas Rd S, Cottage Grove, MN 55016-4035 | 2006-07-24 |
| 1215535430 | Colleen Therese Dougherty | Pharmacy | 7280 E Point Douglas Rd S, Cottage Grove, MN 55016-3016 | 2020-10-09 |
| 1003337023 | Hy Vee Inc | Pharmacy | 7280 E Point Douglas Rd S, Cottage Grove, MN 55016 | 2017-06-29 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | COTTAGE GROVE |
| Zip Code | 55016 |
Please comment or provide details below to improve the information on SUPERVALU PHARMACIES INC.
| 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.