Organization
GRAND ST PAUL CVS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (SR DIRECTOR)
(401) 770-2751
Entity
Organization
Contact information
Practice address
4400 OAK GROVE PARKWAY, BROOKLYN PARK, MN 55443
(763) 315-1935
Mailing address
1 CVS DR # 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
MN
333600000X
Pharmacy
Primary
—
MN
3336C0003X
Community/Retail Pharmacy
—
MN
Other
Enumeration date
07/24/2018
Last updated
10/26/2023
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