Supervalu Pharmacies Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

262023 Issued in MN

Legal business name

SUPERVALU PHARMACIES INC

Doing business as

Cub Pharmacy

Practice address

3784 150TH St W
Rosemount, MN 55068-4761

Phone

(651) 423-0316

Fax

(651) 423-0319

NPI assigned

Aug 20, 2006

Last updated

Oct 3, 2016By the provider in NPPES

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 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Clarkin

  • Athletic Trainer
  • Rosemount, MN
  • NPI 1407459332
  NPD (past)
• Yejay Lor

  • Pharmacist
  • Champlin, MN
  • NPI 1760288237
  NPD (past)
• Julie Szambelan, RPH

  • Pharmacist
  • Rosemount, MN
  • NPI 1023611365
  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": "1730294877",
    "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": "3784 150TH ST W",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550684761",
            "telephone_number": "651-423-0316",
            "fax_number": "651-423-0319"
        }
    ],
    "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": "262023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2048230",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026690600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CUB PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy Lynn Strand, MA, LPCC
• Strokes for Fokls Therapeutic Massage, LLC
• Heidi Struck, M.S.
• Suite Living Senior Care of Rosemount
• Summit Case Management Services LLC
• Julia Verene Suppes
• Support Ventures
• Nicole Suter
• Dana Swanson, M.S.
• Kimberly Swanson, LPCC

• Community/Retail Pharmacy in Rosemount, MN
• Providers in Rosemount, 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.