Organization
SUPERVALU PHARMACIES INC
Active
Other names
CUB PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
AARON SAPP (DIRECTOR OF PHARMACY SERVICES)
(952) 828-4026
Entity
Organization
Contact information
Practice address
1276 TOWN CENTRE DR, EAGAN, MN 55123-1064
(651) 686-0392
(651) 686-0418
Mailing address
11840 VALLEY VIEW RD, ATTN: MANAGED CARE PHARMACY DEPT., EDEN PRAIRIE, MN 55344-3643
(952) 828-4588
(952) 947-3470
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
264453
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295146702
—
MN
01
—
2146379
PK
—
Enumeration date
05/19/2014
Last updated
10/03/2016
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