Organization
SUPERVALU PHARMACIES INC
Active
Other names
CUB PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
AARON SAPP (DIRECTOR OF PHARMACY SERVICES)
(952) 828-4026
Entity
Organization
Contact information
Practice address
701 W BROADWAY AVE, MINNEAPOLIS, MN 55411-2611
(612) 302-8740
(612) 302-8923
Mailing address
11840 VALLEY VIEW RD, ATTN: MANAGED CARE PHARMACY DEPT., EDEN PRAIRIE, MN 55344-3643
(952) 828-4588
(952) 947-3470
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
262458
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2048514
PK
—
05
—
477402700
—
MN
Enumeration date
08/20/2006
Last updated
10/03/2016
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