Grand St Paul CVS LLC
NPI 1366690463ActiveOrganization· Pharmacy· Eden Prairie, MN
Pharmacy in Eden Prairie, Minnesota, registered in NPPES in September 2008. The authorized official on file is Susan Colbert, Director, Payer Relations. Medicare paid $105,273 for services to 420 patients in 2024.
Overview
| NPI | 1366690463 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 3, 2008 |
| Last updated in NPPES | Jun 25, 2012 |
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 | 420 |
|---|---|
| Services billed | 1,356 across 12 procedure codes |
| Paid by Medicare | $105,273 |
Other Pharmacy providers in Eden Prairie
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