CVS PHARMACY #16691 – NPI #1790708089
Pharmacy

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CVS PHARMACY #16691 is a pharmacy located in CHASKA, MN. NPPES has assigned the NPI number 1790708089 to CVS PHARMACY #16691 on July 26, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “CVS PHARMACY #16691” is a dba name, the actual legal business name for this organization is GRAND ST PAUL CVS LLC. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 333600000X from the Health Care Provider Taxonomy code set, which is classified as Pharmacy.

The NPI profile was previously updated about 10 years ago on Nov 15, 2016. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CVS PHARMACY #16691 below.

NPI Profile for
GRAND ST PAUL CVS LLC

NPI Number
1790708089
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GRAND ST PAUL CVS LLC
Doing Business As (dba): CVS PHARMACY #16691
Primary location
111 PIONEER TRL
CHASKA, MN 55318-1121
Phone: (952) 361-3766 Fax: (952) 679-3190
Mailing address
1 CVS DR
MAIL CODE 1090
WOONSOCKET, RI 02895-6146
Phone: (401) 765-1500 Fax:
Organization Subpart
No
Authorized Official
SUSAN COLBERT
SR. DIRECTOR, PAYER RELATIONS
Phone: (401) 770-2751
Updated
Identifiers

Identifiers for CVS PHARMACY #16691

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERPK2048232
MEDICAIDMN550670100
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
333600000X
- Pharmacy (Primary)
3336C0003X
- Pharmacy / Community/Retail Pharmacy
MN 3713
332B00000X
- Durable Medical Equipment & Medical Supplies

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.