Organization
SUPERVALU PHARMACIES INC
Active
Other names
CUB PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE MCCANN (VP PHARMACY)
(952) 828-4531
Entity
Organization
Contact information
Practice address
12595 CENTRAL AVE NE, BLAINE, MN 55434
(763) 767-4329
(763) 767-4553
Mailing address
11840 VALLEY VIEW RD, EDEN PRAIRIE, MN 55344-3643
(952) 828-4588
(952) 947-3470
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
261415
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2047433
PK
—
01
—
2422133
NCPDP
—
05
—
278016000
—
MN
Enumeration date
08/21/2006
Last updated
06/20/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us