Grand St Paul CVS LLC
NPI 1356619415ActiveOrganization· Pharmacy· Detroit Lakes, MN
Pharmacy in Detroit Lakes, Minnesota, registered in NPPES in December 2011. The authorized official on file is Susan Colbert, Director, Payer Relations. Medicare paid $108,203 for services to 403 patients in 2024.
Overview
| NPI | 1356619415 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 5, 2011 |
| Last updated in NPPES | Jan 17, 2023 |
| Certified by provider | Jan 17, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | — | — |
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 | 403 |
|---|---|
| Services billed | 1,374 across 10 procedure codes |
| Paid by Medicare | $108,203 |
Other Pharmacy providers in Detroit Lakes
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- 1861033276