Organization
GRAND ST PAUL CVS STORES LLC
Active
Other names
CVS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA MAURICIO (PHARMACY ENROLLMENT)
(401) 765-1500
Entity
Organization
Contact information
Practice address
15051 GALAXIE AVE, APPLE VALLEY, MN 55124-6987
(952) 432-3535
Mailing address
15051 GALAXIE AVE, APPLE VALLEY, MN 55124-6987
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
262915
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2427765
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/08/2006
Last updated
08/22/2020
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