Supervalu Pharmacies Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

260333 Issued in MN

Legal business name

SUPERVALU PHARMACIES INC

Doing business as

CUB PHARMACY

Practice address

100 County Road B W
Maplewood, MN 55117-1931

Phone

(651) 489-6271

Fax

(651) 487-0966

NPI assigned

Aug 20, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Aaron Sapp

Title

Director of Pharmacy Services

Phone

(952) 828-4026

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• CUB PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bridget Curtin, PHARMD

  • Pharmacist
  • Maplewood, MN
  • NPI 1558150896
  NPD (past)
• Breanne Dietz, PHARM. D

  • Pharmacist
  • Maplewood, MN
  • NPI 1306432356
  NPD (past)
• Arianne Menze, PHARMD

  • Pharmacist
  • Minneapolis, MN
  • NPI 1508263633
  NPD (past)
• Jessica Marie Mulcare, PHARMD

  • Pharmacist
  • Maplewood, MN
  • NPI 1730623265
  NPD (past)
• Stuart James Remus, RPH

  • Pharmacist
  • Maplewood, MN
  • NPI 1124221577
  NPD (past)
• Tony Zoovdue Yalo

  • Pharmacist
  • Maplewood, MN
  • NPI 1285221895
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475452800000",
    "number": "1407961543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11840 VALLEY VIEW RD",
            "address_2": "ATTN: MANAGED CARE PHARMACY DEPT.",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443643",
            "telephone_number": "952-828-4588",
            "fax_number": "952-947-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COUNTY ROAD B W",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551171931",
            "telephone_number": "651-489-6271",
            "fax_number": "651-487-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERVALU PHARMACIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2016-10-03",
        "status": "A",
        "authorized_official_last_name": "SAPP",
        "authorized_official_first_name": "AARON",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY SERVICES",
        "authorized_official_telephone_number": "952-828-4026"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "260333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "660058100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2046387",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CUB PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan Yiquan Sun, MD
• Xiaoguang Sun, MD
• Sunfish Senior Center Inc
• Superior Health and Human Services of MN
• Supervalu Pharmacies Inc
• Kari Elaine Swanson I I, CNP
• Julie Swedburg, MS, CCC-SLP
• Miranda Biegon Swensen, DPT
• Krista Swenson, MD
• Meghan Michelle Swenson, B.A.

• Community/Retail Pharmacy in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Community/Retail Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.