Organization
GRAND ST PAUL CVS LLC
Active
Other names
CVS PHARMACY #06715
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
4241 JOHNNY CAKE RIDGE RD, EAGAN, MN 55122-2235
(651) 688-7041
Mailing address
1 CVS DR, PO BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
262487-9
MN
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2426181
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/25/2006
Last updated
06/22/2022
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