Cvs Pharmacy #16594

LBN: Grand St Paul Cvs Llc
Cvs Pharmacy #16594 is an health care organization with primary practice located at 356 12Th St Sw , Forest Lake MN 55025-1749. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Grand St Paul Cvs Llc can be contacted via phone (651) 464-1994, or through Colbert, Susan via phone (401) 770-2751.

Contact Information

Primary practice address
356 12Th St Sw Forest Lake MN 55025-1749
Fax: (651) 234-3181
Website:
Authorized official contact:
Name: Colbert, Susan

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 62395 Minnesota

Profile Details

NPI number 1780606475
LBN Legal business name Grand St Paul Cvs Llc
DBA Doing business as Cvs Pharmacy #16594
Authorized official Colbert, Susan
Entity Organization
Organization subpart 1 No
Enumeration date Jul 24th, 2006
Last updated Nov 15th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780606475 NPPES
Minnesota MEDICAID 440085200
Minnesota Other 2048146

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