Cvs Pharmacy #17453
LBN: Grand St Paul Cvs Llc
Cvs Pharmacy #17453 is an health care organization with primary practice located at 15560 Pilot Knob Rd , Apple Valley MN 55124-7286. 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 (952) 236-3166, or through Colbert, Susan via phone (401) 770-2751.
Contact Information
Primary practice address
15560 Pilot Knob Rd
Apple Valley MN 55124-7286
Phone: (952) 236-3166
Fax: (952) 236-3176
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | ||
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 263150 | Minnesota |
Profile Details
| NPI number | 1922285956 |
|---|---|
| LBN Legal business name | Grand St Paul Cvs Llc |
| DBA Doing business as | Cvs Pharmacy #17453 |
| Authorized official | Colbert, Susan |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 22nd, 2008 |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1922285956 | NPPES |
| Other | 2049353 | PK | |
| MEDICAID | 026637200 | PK |
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