Organization
SUPERVALU PHARMACIES INC.
Active
Other names
CUB PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA O'CONNELL (SR MANAGER MANAGED CARE)
(651) 779-4023
Entity
Organization
Contact information
Practice address
1750 COUNTY ROAD 42 W, BURNSVILLE, MN 55337-6200
(952) 800-0988
Mailing address
421 3RD ST S, STILLWATER, MN 55082-4955
(651) 779-4023
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
03/24/2025
Last updated
03/24/2025
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