Cvs Pharmacy #17503

LBN: Grand St Paul Cvs Llc
Cvs Pharmacy #17503 is an health care organization with primary practice located at 875 E Main St , Waconia MN 55387-1081. The organization recently has 2 registered licenses in different health care specialties including 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) 442-9334, or through Colbert, Susan via phone (401) 770-2751.

Contact Information

Primary practice address
875 E Main St Waconia MN 55387-1081
Phone: (952) 442-9334
Fax: (952) 442-9343
Website:
Map and Directions
Authorized official contact:
Name: Colbert, Susan
Phone: (401) 770-2751

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 263240 Minnesota

Profile Details

NPI number 1629226626
LBN Legal business name Grand St Paul Cvs Llc
DBA Doing business as Cvs Pharmacy #17503
Authorized official Colbert, Susan
Entity Organization
Organization subpart 1 No
Enumeration date Sep 3rd, 2008
Last updated Nov 21st, 2016 - about 10 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 1629226626 NPPES
Other 2116799 PK
MEDICAID 896477000 PK

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