GRAND ST. PAUL CVS, LLC. (NPI# 1841549557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841549557 |
| Entity Type | Organization |
| Organization Name | GRAND ST. PAUL CVS, LLC. |
| Other Organization Name | CVS PHARMACY # 05472 |
| Practice Address |
12751 Nicollet Ave Burnsville MN 55337-2890 |
| Mailing Address |
1 Cvs Dr Box 1075 Pharmacy Enrollments Woonsocket RI 02895-6146 |
| Practice Telephone | 9527368130 |
| Mailing Telephone | 4017651500 |
| Mailing Fax Number | 4017707108 |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2013-04-12 |
| 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 | 1841549557 | 05 | |
| MN | NCPDP | 2431613 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY # 05472 | Doing Business As Name - Organization |
| Street Address |
12751 NICOLLET AVE |
| City | BURNSVILLE |
| State | MN |
| Zip Code | 55337-2890 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710505540 | Kaitlin Miller | Pharmacist | 12751 Nicollet Ave, Burnsville, MN 55337-2806 | 2020-07-08 |
| 1194345207 | Amanda Michelle Reinert Nash | Pharmacist | 12751 Nicollet Ave, Burnsville, MN 55337-2806 | 2020-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053939397 | Alpha Quality Care1 L. L. C. | Home Infusion | 12924 18th Ave South, Burnsville, MN 55337 | 2020-07-13 |
| 1568085900 | Kathryn Harris | Counselor | 11939 W. River Hills Dr., Burnsville, MN 55337 | 2020-05-20 |
| 1952941254 | Noah Home Care Inc. | Home Health | 13521 Nicollet Lane, Burnsville, MN 55337 | 2020-01-14 |
| 1750854287 | Baraka Home Care LLC | Nursing Care | 1700 James Place, Burnsville, MN 55337 | 2019-01-08 |
| 1699298778 | Raphael Cheron-dittmann | Hearing Instrument Specialist | 14000 Nicollet Ave. S., Suite 303, Burnsville, MN 55337 | 2017-07-20 |
| 1669909818 | Mercy Home Care Ltd | Hospice Care, Community Based | 1020 E 146th St Ste 220d, Burnsville, MN 55337 | 2017-05-18 |
| 1457893984 | Daniel Ryan Nguyen | Physician Assistant | 14551 Co Rd #11 #100, Burnsville, MN 55337 | 2016-11-15 |
| 1730542572 | Iris Reproductive Psychiatric Clinic | Clinical Nurse Specialist | 1500 Mcandrews Road W, Ste 227, Burnsville, MN 55337 | 2016-03-30 |
| 1740657204 | Mercy Link, LLC | Home Health | 13005 Salem Pl, Burnsville, MN 55337 | 2015-08-31 |
| 1669852158 | Mixa Dipak Patel | Physical Therapy Assistant | 8380 Hiawatha Ave, Eden Prairie, MN 55337 | 2015-06-01 |
| Find all providers in zip 55337 | ||||
| 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 |
|---|---|---|---|---|
| 1750699468 | Heritage Pharmacy Inc | Pharmacy | 1722 W Us Highway 19e, Burnsville, NC 28714-8602 | 2010-09-15 |
| 1104919398 | Bi Lo LLC | Pharmacy | 35 West Bypass, Burnsville, NC 28714 | 2006-10-02 |
| 1487760898 | Supervalu Pharmacies Inc | Pharmacy | 1750 County Road 42 W, Burnsville, MN 55337 | 2006-08-21 |
| 1316052459 | Supervalu Pharmacies Inc | Pharmacy | 300 E Travelers Trl, Burnsville, MN 55337-2885 | 2006-08-20 |
| 1003289257 | Fairview Pharmacy Services LLC | Pharmacy | 14101 Fairview Dr, Suite 100, Burnsville, MN 55337-4590 | 2015-11-10 |
| 1831274778 | Byerlys Inc | Pharmacy | 401 County Road 42 E, Burnsville, MN 55306-5706 | 2006-10-26 |
| 1598849242 | Fairview Health Servcies | Pharmacy | 201 E Nicollet Blvd, Burnsville, MN 55337-5714 | 2006-10-25 |
| 1205867207 | K Mart Corp | Pharmacy | 14230 Burnhaven Dr, Burnsville, MN 55306-4930 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861033276 | Nina Marie Kleinschmidt | Pharmacy | 1315 Minnesota Ave, Detroit Lakes, MN 56501-3913 | 2019-10-07 |
| 1659837698 | Bpoint Pharmacy Services Ltd | Pharmacy | 30833 North Star Dr, Suite 2, Breezy Point, MN 56472 | 2019-02-14 |
| 1477042372 | Sanford Clinic North | Pharmacy | 1611 Anne St Nw Ste 1, Bemidji, MN 56601-5114 | 2018-05-07 |
| 1295222909 | A & E Pharmacy LLC | Pharmacy | 1509 10th Ave S, Minneapolis, MN 55404-1754 | 2018-04-18 |
| 1215445085 | Genoa Healthcare LLC | Pharmacy | 8441 Wayzata Blvd, Suite 340, Golden Valley, MN 55426-1372 | 2018-01-16 |
| 1497279608 | Coborns Inc | Pharmacy | 110 1st St S Ste B, Sauk Rapids, MN 56379-1404 | 2017-07-29 |
| 1740711753 | Hennepin Healthcare System Inc | Pharmacy | 800 Washington Ave N Ste 190, Minneapolis, MN 55401-1330 | 2017-03-22 |
| 1568903532 | First Choice Pharmacy of Jordan PC | Pharmacy | 165 West Commerce Drive, Suite 110, Belle Plaine, MN 56011 | 2017-03-10 |
| 1013454545 | Genesis Recovery Services, LLC | Pharmacy | 5 N 3rd Ave W Ste 302, Duluth, MN 55802-1614 | 2017-01-23 |
| 1104360973 | Group Health Plan, Inc. | Pharmacy | 3800 Park Nicollet Blvd Ste 1170, St Louis Park, MN 55416-2527 | 2016-12-13 |
| Find all providers with the same taxonomy | ||||
| City | BURNSVILLE |
| Zip Code | 55337 |
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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.