Organization
SUPERVALU PHARMACIES INC
Active
Other names
CUB PHARMACY #1718
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA O'CONNELL (MANAGER, MANAGED CARE)
(651) 779-4023
Entity
Organization
Contact information
Practice address
2480 SCOTT RD NW, SUITE 100, ROCHESTER, MN 55901
(651) 779-4023
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
—
—
Other
Enumeration date
01/11/2024
Last updated
01/11/2024
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