Organization
GRAND ST PAUL CVS LLC
Active
Other names
CVS Pharmacy # 03054
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F. COLBERT (SR. DIRECTOR, PAYER RELATIONS)
(401) 765-1500
Entity
Organization
Contact information
Practice address
1175 MADISON AVE, MANKATO, MN 56001-5227
(507) 625-1791
(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
Enumeration date
01/06/2011
Last updated
08/02/2024
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