Grand St Paul Cvs LLC

NPI #1952323636 in Baxter, Minnesota

Provider Information

NPI Number: 1952323636
Entity Type: Organization
Organization Name: Grand St Paul Cvs LLC
Primary Specialty: Pharmacy
Enumeration Date: Jul 24, 2006
Last Updated: Jan 19, 2023

Practice Location

Address: 14546 DELLWOOD DR
City: Baxter
State: Minnesota
ZIP Code: 56425-9744
Phone: (218) 828-9219

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Durable Medical Equipment & Medical Supplies	332B00000X
Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy	3336C0003X
Pharmacy	333600000X	Primary

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