Supervalu Pharmacies Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

261660 Issued in MN

Legal business name

SUPERVALU PHARMACIES INC

Practice address

1750 County Road 42 W
Burnsville, MN 55337

Phone

(952) 892-6262

Fax

(952) 892-6183

NPI assigned

Aug 21, 2006

Organization subpart

No

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

Authorized official

Name

Steve McCann

Title

VP Pharmacy

Phone

(952) 828-4531

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• CUB PHARMACY Doing business as

Locations

Practitioners 5

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

• Robert L Hagie, PHARMD

  • Pharmacist
  • Burnsville, MN
  • NPI 1497187249
  NPD (past)
• Patrick James Messelt, R.PH

  • Pharmacist
  • Burnsville, MN
  • NPI 1982823555
  NPD (past)
• Bridget Jean Ogden, PHARM.D

  • Pharmacist
  • Burnsville, MN
  • NPI 1083909816
  NPD (past)
• Robin Peterson, PHARMD

  • Pharmacist
  • Saint Paul, MN
  • NPI 1346694189
  NPD (past)
• Emily Skjeveland

  • Pharmacist
  • Burnsville, MN
  • NPI 1336894534
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707782400000",
    "number": "1487760898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 3RD ST S",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550824955",
            "telephone_number": "651-779-4023",
            "fax_number": "651-779-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 COUNTY ROAD 42 W",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "55337",
            "telephone_number": "952-892-6262",
            "fax_number": "952-892-6183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERVALU PHARMACIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A",
        "authorized_official_last_name": "MCCANN",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "VP PHARMACY",
        "authorized_official_telephone_number": "952-828-4531"
    },
    "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": "261660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2048082",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "991324600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2423301",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CUB PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CUB PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Sunny S. Kim, MD PA
• Sunny S. Kim, MD PA
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• Supervalu Pharmacies Inc
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• Sara Supplee, RDN LD
• Supported Living Solutions, LLC
• Robin Sutton
• Suzanne L. Krueger & Associates PC

• All providers in Burnsville, MN
• Community/Retail Pharmacy in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.