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GRAND ST PAUL CVS LLC NPI 1215959903


NPI Information

NPI: 1215959903
Provider Name: GRAND ST PAUL CVS LLC

Doing Business As: CVS PHARMACY #16953

Classification: Pharmacy - 333600000X
Entity Type: Organization
Address:
1500 109TH AVE NE
BLAINE, MN
ZIP 55449
Phone: (763) 354-1001
Get Directions

GRAND ST PAUL CVS LLC is a pharmacy in Blaine, 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 1215959903. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy #16953.

The provider's business location address is:

1500 109TH AVE NE
BLAINE, MN
ZIP 55449-670
Phone: (763) 354-1001
Fax: (763) 354-1001

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 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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
23336C0003XPharmacyCommunity/Retail Pharmacy616834MINNESOTANo
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12048459OTHERPK
20640710843MEDICARE NSC
3692677100MEDICAIDMINNESOTA
45603920109MEDICARE NSC

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: 5/5/2024

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