GRAND ST PAUL CVS LLC (NPI# 1174065007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174065007 |
| Entity Type | Organization |
| Organization Name | GRAND ST PAUL CVS LLC |
| Other Organization Name | CVS PHARMACY #10902 |
| Practice Address |
30 Fairview Ave S Saint Paul MN 55105-1463 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 6516996008 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2017-04-04 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR) |
| 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 | 2433364 | 01 |
| MN | 1174065007 | 05 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY #10902 | 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 |
| 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 |
| 1093060725 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 4528 Grand Ave, Duluth, MN 55807-2740 | 2012-07-18 |
| 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 |
30 FAIRVIEW AVE S |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55105-1463 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174158067 | Haley Wochner | Pharmacist | 30 Fairview Ave S, Saint Paul, MN 55105-1463 | 2020-03-11 |
| 1689209066 | Nancy Nguyen | Pharmacist | 30 Fairview Ave S, Saint Paul, MN 55105-1463 | 2020-03-06 |
| 1255966552 | Thuy Anh Thi Tran | Pharmacist | 30 Fairview Ave S, Saint Paul, MN 55105-1463 | 2020-03-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437704020 | Grand Avenue Smiles | Dentist | 1845 Grand Avenue, St. Paul, MN 55105 | 2019-08-09 |
| 1205304839 | Michelle Marie Loken Price | Acupuncturist | 877 Lincoln Ave, Saint Paul, MN 55105 | 2018-11-13 |
| 1326566936 | Becky Lynn Lawyer | Counselor | 1704 Palace Ave, St Paul, MN 55105 | 2017-09-04 |
| 1679020226 | Internal Revolution Counseling and Consulting, L.L.C. | Psychologist | 1123 Grand Avenue, Suite 201, Saint Paul, MN 55105 | 2016-09-01 |
| 1487059689 | Jennifer Mason | Lactation Consultant, Non-RN | 1382 Summit Ave, Saint Paul, MN 55105 | 2014-10-30 |
| 1679818850 | Marc Lane Wolfson | Registered Nurse | 1148 Grand Avenue, St. Paul, MN 55105 | 2012-11-29 |
| 1457602781 | Charting Your Success | Social Worker | 2050 St Clair Avenue, Suite 1e, St Paul, MN 55105 | 2012-09-26 |
| 1871867549 | Stacia Hanson Ma Lp LLC | Psychologist | 889 Grand Avenue, Suite 203, St Paul, MN 55105 | 2012-02-28 |
| 1265718142 | Caitlin Marie Young | Midwife | 968 Grand Ave., St. Paul, MN 55105 | 2011-10-24 |
| 1659512622 | Wellness Cooperative LLC | Chiropractor | 976 Grand Ave., St. Paul, MN 55105 | 2009-03-20 |
| Find all providers in zip 55105 | ||||
| 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 |
|---|---|---|---|---|
| 1518323997 | Genoa Healthcare, LLC | Pharmacy | 166 4th St E Ste 244, Saint Paul, MN 55101-1421 | 2016-01-14 |
| 1346635059 | Brightly Pharmacy Care Inc | Pharmacy | 1239 Payne Ave Ste 202, Saint Paul, MN 55130-3667 | 2015-03-31 |
| 1447323480 | Alchemist General Inc | Pharmacy | 694 Snelling Ave N, Suite A, Saint Paul, MN 55104 | 2006-11-16 |
| 1386738631 | Snyders Drug | Pharmacy | 2920 Rice St, Saint Paul, MN 55113-2230 | 2006-10-03 |
| 1982798385 | Snyders Drug | Pharmacy | 1867 Robert St S, Saint Paul, MN 55118-3904 | 2006-10-03 |
| 1245324649 | Snyders Drug Stores Inc | Pharmacy | 800 White Bear Ave N, Saint Paul, MN 55106-4319 | 2006-10-03 |
| 1619061017 | Snyders Drug | Pharmacy | 1121 Larpenteur Ave W, Saint Paul, MN 55113-6335 | 2006-10-03 |
| 1861480519 | Rbf LLC | Pharmacy | 892 Arcade St, Saint Paul, MN 55106-3852 | 2005-10-06 |
| 1447883269 | Children's Health Care | Pharmacy | 345 Smith Ave N, Saint Paul, MN 55102-2346 | 2020-02-20 |
| 1386778090 | James A Swinarski | Pharmacy | 624 Howard Ave, Saint Paul, NE 68873-2023 | 2007-03-15 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55105 |
Please comment or provide details below to improve the information on GRAND ST PAUL CVS LLC.
| 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.