Grand St Paul CVS LLC
NPI 1063512374ActiveOrganization· Pharmacy· St Louis Park, MN
Pharmacy in St Louis Park, Minnesota, registered in NPPES in September 2006. The authorized official on file is Susan Colbert, Sr. Director, Payer Relations. Medicare paid $54,418 for services to 219 patients in 2024.
Overview
| NPI | 1063512374 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 25, 2006 |
| Last updated in NPPES | Dec 5, 2024 |
| Certified by provider | Dec 5, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | 262885 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Pharmacy (MN) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 219 |
|---|---|
| Services billed | 682 across 10 procedure codes |
| Paid by Medicare | $54,418 |
Other Pharmacy providers in St Louis Park
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