Active NPI
Grand St Paul CVS Phcy LLC
Doing business as CVS Pharmacy
- Community/Retail Pharmacy
- Lakeville, MN
National Provider Identifier
1487748760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 262890
- Legal business name
- GRAND ST PAUL CVS PHCY LLC
- Doing business as
- CVS Pharmacy
- Practice address
- 17578 Dood Blvd
Lakeville, MN 55044 - Phone
- (952) 432-8770
- NPI assigned
- Oct 3, 2006
- Last updated
- Aug 22, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Claudia Marinaro
- Title
- Phcy Enrollment Rep
- Phone
- (401) 765-1500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 262890 | MN | Primary |
Addresses
Primary practice location
17578 Dood Blvd
Lakeville, MN 55044
Mailing address
17578 Dood Blvd
Lakeville, MN 55044
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2427690 | Other | OTHER ID NUMBER-COMMERCIAL NUMBER |
Other names 1
- CVS PHARMACY
National Provider Directory
National Provider Directory- Tax ID family
- Grand St Paul CVS Phcy LLC
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Pharmacy
- Brooklyn Park, MN
- NPI 1487131330
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1487748760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17578 DOOD BLVD",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "55044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17578 DOOD BLVD",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "55044",
"telephone_number": "952-432-8770"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRAND ST PAUL CVS PHCY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-03",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MARINARO",
"authorized_official_first_name": "CLAUDIA",
"authorized_official_title_or_position": "PHCY ENROLLMENT REP",
"authorized_official_telephone_number": "401-765-1500"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MN",
"license": "262890",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
"identifier": "2427690",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "CVS PHARMACY",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Lakeville, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.