GRAND ST PAUL CVS LLC NPI 1609975911

NPI Information

  • NPI: 1609975911
  • Provider Name: GRAND ST PAUL CVS LLC
  • Classification: Pharmacy - 333600000X
  • Entity Type: Organization
  • Doing Business As: CVS PHARMACY #01746
  • CLIA Number: 24D2256000
  • Address: 2150 EAGLE CREEK LN
    WOODBURY, MN
    ZIP 55129
  • Phone: (651) 436-4732

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NPI Details

GRAND ST PAUL CVS LLC is a pharmacy in Woodbury, 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 1609975911. The provider is registered as an organization entity type.
The provider Is Doing Business As Cvs Pharmacy #01746.

The provider's business location address is:

2150 EAGLE CREEK LN
WOODBURY, MN
ZIP 55129-201
Phone: (651) 436-4732

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

The CLIA number assigned to this NPI record is 24D2256000 - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count (HCPCS:K1034)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Fee covid-19 vac 13 res (HCPCS:0124A)
  • Adm sarscv2 30mcg trs-sucr 3 (HCPCS:0053A)
  • Adm sarscv2 30mcg trs-sucr b (HCPCS:0054A)
  • Influenza vaccine, quadrivalent inactivated, 0.5 ml dosage (HCPCS:90694)

The enumeration date for this NPI number is 9/22/2006 and was last updated on 11/18/2010.

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
13336C0003XPharmacyCommunity/Retail PharmacyNo
2332B00000XDurable Medical Equipment & Medical SuppliesNo
3333600000XPharmacy2626657MINNESOTAYes

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
15603920035MEDICARE NSC
2010602000MEDICAIDMINNESOTA
3730000099MEDICARE PIN
42427068OTHEROTHER ID NUMBER-COMMERCIAL NUMBER

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: 11/21/2025

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