Organization Name: | GRAND ST PAUL CVS LLC |
NPI Number: | 1851461792 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN COLBERT (DIRECTOR, PAYER RELATIONS) |
Mailing Address: | 5696 University Ave Ne Fridley |
State: | MN US |
Postal Code: | 554325579 |
Phone Number: | 7635712081 |
Fax Number: | 4017707108 |
NPI Enumeration Date: | 11/08/2006 |
NPI Last Update Date: | 03/07/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |