Organization
GRAND ST PAUL CVS LLC
Active
Other names
CVS Pharmacy # 08285
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
(401) 770-2751
Entity
Organization
Contact information
Practice address
1010 W LAKE ST, MINNEAPOLIS, MN 55408-2860
(612) 822-1297
(401) 770-7108
Mailing address
1 CVS DR, WOONSOCKET, RI 02895-6146
(401) 765-1500
(401) 770-7108
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467774463
—
MN
01
—
2430065
NCPDP
MN
Enumeration date
02/18/2010
Last updated
11/19/2010
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