GRAND ST PAUL CVS LLC (NPI# 1093060725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093060725 |
Entity Type | Organization |
Organization Name | GRAND ST PAUL CVS LLC |
Other Organization Name | CVS PHARMACY # 06686 |
Practice Address |
4528 Grand Ave Duluth MN 55807-2740 |
Mailing Address |
1 Cvs Dr Woonsocket RI 02895-6146 |
Practice Telephone | 2186242820 |
Mailing Telephone | 4017651500 |
Enumeration Date | 2012-07-18 |
Last Update Date | 2015-08-28 |
Authorized Official Name | SUSAN F. COLBERT (DIRECTOR, PAYER RELATIONS) |
Authorized Official Telephone | 4017651500 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
Y | 333600000X | Pharmacy | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | NCPDP | 2431500 | 01 |
MN | 1093060725 | 05 |
Other Name | Type Code |
---|---|
CVS PHARMACY # 06686 | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437620903 | Grand St Paul Cvs LLC | Pharmacy | 17435 County Road 6, Plymouth, MN 55447-3046 | 2018-12-10 |
1174065007 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 30 Fairview Ave S, Saint Paul, MN 55105-1463 | 2016-11-09 |
1316327042 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 740 Railroad Ave, Albany, MN 56307-9456 | 2015-06-08 |
1194126995 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 1411 Vermillion, Hastings, MN 55033 | 2014-09-11 |
1952715096 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 1215 E Superior St, Duluth, MN 55802-2218 | 2014-06-17 |
1598101362 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 25 2nd St Ne, Aitkin, MN 56431-1419 | 2013-05-20 |
1326392762 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 1000 Nicollet Mall # 0272, Minneapolis, MN 55403-2542 | 2012-11-07 |
1821356171 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 2323 Highway 3 S, Northfield, MN 55057-5172 | 2012-04-24 |
1861760738 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 6540 Penn Ave S, Richfield, MN 55423-1143 | 2011-12-07 |
1356619415 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 329 Frazee St E, Detroit Lakes, MN 56501-3603 | 2011-12-05 |
Street Address |
4528 GRAND AVE |
City | DULUTH |
State | MN |
Zip Code | 55807-2740 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386270130 | Kelsey Lynn Mcmurtry | Pharmacist | 4528 Grand Ave, Duluth, MN 55807-2740 | 2020-03-12 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568918126 | Jaime Lynn Mallory | Counselor | 4000 W 9th St., Duluth, MN 55807 | 2016-09-01 |
1568817138 | Fathers Rise Together | Community/Behavioral Health | 319 N 22nd Ave West, Duluth, MN 55807 | 2016-05-02 |
1558660357 | Melissa June Huray | Counselor | 326 North Central Avenue, Duluth, MN 55807 | 2011-03-18 |
1376757682 | Chiropractic Health Center P A | Chiropractor | 215 North Central Ave, Duluth, MN 55807 | 2007-05-09 |
1639235914 | Mark Andrew Nelson Albee | Social Worker | 4214 Grand Avenue, Duluth Clinic-west, Duluth, MN 55807 | 2006-12-29 |
1851457758 | Northwood Children's Services, Inc. | Counselor | 4000 W 9th St, Duluth, MN 55807 | 2006-12-28 |
1679934012 | Rebecca Ann Peterson | Nurse Practitioner | 4325 Grand Ave, Duluth, MN 55807 | 2016-03-13 |
1326134529 | Jane Patricia Rudd | Family Medicine | 4212 Grand Ave, Duluth, MN 55807 | 2006-10-05 |
1548290257 | Kirsten I Bich | Family Medicine | 4212 Grand Ave, Essentia Health West Duluth Clinic, Duluth, MN 55807 | 2006-07-05 |
1033140660 | Wendell R Bonner | Family Medicine | 4212 Grand Ave, Duluth, MN 55807 | 2006-07-05 |
Find all providers in zip 55807 |
Taxonomy Code | 333600000X |
Grouping | Suppliers |
Classification | Pharmacy |
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. |
Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013454545 | Genesis Recovery Services, LLC | Pharmacy | 5 N 3rd Ave W Ste 302, Duluth, MN 55802-1614 | 2017-01-23 |
1710392790 | Express Pharmacy Inc | Pharmacy | 1630 Pleasant Hill Rd Unit C3, Duluth, GA 30096-5899 | 2014-06-27 |
1366883860 | Annapurna Pharmacies, Inc | Pharmacy | 3585 Peachtree Industrial Blvd Ste 168, Duluth, GA 30096-6370 | 2013-07-12 |
1891063780 | Walgreens | Pharmacy | 3100 Bugle Dr, Duluth, GA 30096-3526 | 2011-12-06 |
1912121187 | Sung Hyun Inc | Pharmacy | 3230 Steve Reynolds Blvd Ste 114, Duluth, GA 30096-8833 | 2007-04-12 |
1851403794 | Decatur Apothecary | Pharmacy | 3055 Saint Andrews Dr, Duluth, GA 30096-3584 | 2006-08-31 |
1356380364 | Publix Super Markets Inc | Pharmacy | 3870 Peachtree Industrial Blvd, Duluth, GA 30096-1422 | 2006-06-05 |
1083690911 | Hyungwon Kang | Pharmacy | 2550 Pleasant Hill Rd # Build100, Ste 126, Duluth, GA 30096-4122 | 2005-12-22 |
1114901550 | Falks Woodland Pharmacy Inc | Pharmacy | 5300 Bristol St, Duluth, MN 55807-2903 | 2005-11-30 |
1780668137 | Falks Woodland Pharmacy Inc | Pharmacy | 1352 W Arrowhead Rd, Duluth, MN 55811-2218 | 2005-11-30 |
Find all providers in DULUTH |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.