Grand St Paul Cvs LLC
NPI #1780606475 in Forest Lake, Minnesota
Provider Information
- NPI Number
- 1780606475
- Entity Type
- Organization
- Organization Name
- Grand St Paul Cvs LLC
- Primary Specialty
- Pharmacy
- Enumeration Date
- Jul 24, 2006
- Last Updated
- Nov 15, 2016
Practice Location
- Address
- 356 12TH ST SW
- City
- Forest Lake
- State
- Minnesota
- ZIP Code
- 55025-1749
- Phone
- (651) 464-1994
Authorized Official
- Name
- SUSAN COLBERT
- Title
- SR. DIRECTOR, PAYER RELATIONS
- Phone
- (401) 770-2751
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
| Durable Medical Equipment & Medical Supplies |
| Pharmacy |
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