Supervalu Pharmacies Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

261060 Issued in MN

Legal business name

SUPERVALU PHARMACIES INC

Doing business as

Cub Pharmacy

Practice address

1059 Meadowlands Dr
White Bear Lake, MN 55127-2346

Phone

(651) 426-5006

Fax

(651) 426-5711

NPI assigned

Aug 20, 2006

Last updated

Oct 23, 2026By 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

Jessica O'Connell

Title

Sr Manager, Managed Care

Phone

(651) 779-4023

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• CUB PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792713600000",
    "number": "1760597801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 990",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554400990",
            "telephone_number": "651-779-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1059 MEADOWLANDS DR",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551272346",
            "telephone_number": "651-426-5006",
            "fax_number": "651-426-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPERVALU PHARMACIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2026-10-23",
        "certification_date": "2026-10-23",
        "status": "A",
        "authorized_official_last_name": "O'CONNELL",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "SR MANAGER, MANAGED CARE",
        "authorized_official_telephone_number": "651-779-4023"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "261060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2047021",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "719319000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CUB PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Samantha Stroik
• Suite Living Hospice Care, LLC
• Leif Per-Alden Sundberg, PA-C
• Margaret E Sundell, M.A., NCTMB
• Sunstone Counseling LLC
• Supervalu Pharmacies Inc (Cub Pharmacy)
• Ellie Swallen
• Jacob Patrick Swallen
• Brenda Kay Sweet, BIRTH DOULA
• Ellen Patricia Swift, DDS

• Community/Retail Pharmacy in White Bear Lake, MN
• Providers in White Bear Lake, 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 23, 2026; 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.