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Contact Information

GRAND ST PAUL CVS LLC
8251 COLUMBINE RD.
EDEN PRAIRIE, MN55344
 Phone: 952-941-1266
 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 # 1366690463
LBN Legal business name GRAND ST PAUL CVS LLC
Authorized official SUSAN COLBERT - (DIRECTOR, PAYER RELATIONS)
Entity Organization
Organization subpart 1 No
Enumeration date 09/03/2008
Last updated 06/25/2012 - About 14 years ago
Identifiers
MN Medicaid 362412100
Other 2429214 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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