Cvs Pharmacy #16852

LBN: Grand St Paul Cvs Llc
Cvs Pharmacy #16852 is an health care organization with primary practice located at 151 Tyler Rd N , Red Wing MN 55066-1865. 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) 388-2433, or through Colbert, Susan via phone (401) 770-2751.

Contact Information

Primary practice address
151 Tyler Rd N Red Wing MN 55066-1865
Fax: (651) 388-2433
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 2622680 Minnesota

Profile Details

NPI number 1689696379
LBN Legal business name Grand St Paul Cvs Llc
DBA Doing business as Cvs Pharmacy #16852
Authorized official Colbert, Susan
Entity Organization
Organization subpart 1 No
Enumeration date Jul 24th, 2006
Last updated Nov 15th, 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 1689696379 NPPES
Wisconsin MEDICAID 1689696379
Wisconsin MEDICAID 140118100
Wisconsin Other 2048375

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