Provider Type Icon

GRAND ST PAUL CVS LLC NPI 1376565044


NPI Information

NPI: 1376565044
Provider Name: GRAND ST PAUL CVS LLC

Doing Business As: CVS PHARMACY #16002

Classification: Pharmacy - 333600000X
Entity Type: Organization

CLIA Number: 24D2217648

Address:
2555 W 79TH ST
BLOOMINGTON, MN
ZIP 55431
Phone: (952) 888-4677
Get Directions

GRAND ST PAUL CVS LLC is a pharmacy in Bloomington, MN. The provider is 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. GRAND ST PAUL CVS LLC NPI is 1376565044. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy #16002.

The provider's business location address is:

2555 W 79TH ST
BLOOMINGTON, MN
ZIP 55431-250
Phone: (952) 888-4677
Fax: (952) 356-3921

The provider's authorized official is Susan Colbert .
The authorized official title is Sr. Director, Payer Relations and has the following contact phone number (401) 770-2751.

The CLIA number assigned to this NPI record is 24D2217648 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/24/2006 and was last updated on 11/21/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail Pharmacy8992MINNESOTANo
3333600000XPharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15603920120MEDICARE NSC
20640710134MEDICARE NSC
32043865OTHERPK
4259058100MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.