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Contact Information

GRAND ST PAUL CVS, LLC
2420 DIVISION ST
SAINT CLOUD, MN56301
 Phone: 320-253-5366
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for GRAND ST PAUL CVS, LLC

NPI # 1063759546
LBN Legal business name GRAND ST PAUL CVS, LLC
Authorized official SUSAN COLBERT - (DIRECTOR, PAYER RELATIONS)
Entity Organization
Organization subpart 1 No
Enumeration date 01/03/2013
Last updated 04/12/2013 - About 13 years ago
Identifiers
MN Medicaid 1063759546
MN Other 2431740 NCPDP
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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