Organization
SUPERVALU PHARMACIES INC
Active
Other names
CUB SPECIALTY PHARMACY #1964, SUPERVALU PHARMACIES SPECIALTY SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
AARON SAPP (DIRECTOR OF PHARMACY SERVICES)
(952) 828-4026
Entity
Organization
Contact information
Practice address
421 3RD ST S, STILLWATER, MN 55082-4955
(651) 439-0557
(651) 439-0637
Mailing address
421 3RD ST S, STILLWATER, MN 55082-4955
(651) 779-4023
(651) 779-2023
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
265075
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159821
PK
—
Enumeration date
04/27/2016
Last updated
12/22/2023
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