Grand St Paul Cvs LLC

NPI #1215959903 in Blaine, Minnesota

Provider Information

NPI Number
1215959903
Entity Type
Organization
Organization Name
Grand St Paul Cvs LLC
Primary Specialty
Pharmacy
Enumeration Date
Jul 24, 2006
Last Updated
Nov 21, 2016

Practice Location

Address
1500 109TH AVE NE
City
Blaine
ZIP Code
55449-4670
Phone
(763) 354-1001

Authorized Official

Name
SUSAN COLBERT
Title
SR. DIRECTOR, PAYER RELATIONS
Phone
(401) 770-2751

Specialties & Taxonomy Codes

Specialty
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy
Durable Medical Equipment & Medical Supplies
Pharmacy

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