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
2612 S BROADWAY ST, ALEXANDRIA, MN 56308-3415
(320) 759-1135
(320) 759-1442
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
264711
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841685591
—
MN
01
—
2151107
PK
—
Enumeration date
03/31/2015
Last updated
10/03/2016
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