Grand St Paul CVS LLC
NPI 1396767075ActiveOrganization· Pharmacy· Grand Rapids, MN
Pharmacy in Grand Rapids, Minnesota, registered in NPPES in July 2006. The authorized official on file is Susan Colbert, Sr. Director, Payer Relations. Medicare paid $89,595 for services to 322 patients in 2024.
Overview
| NPI | 1396767075 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 24, 2006 |
| Last updated in NPPES | Nov 15, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Pharmacy Primary | 333600000X | — | — |
| Durable Medical Equipment & Medical Supplies | 332B00000X | — | — |
| Pharmacy, Community/Retail Pharmacy | 3336C0003X | 340283 | 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 | 322 |
|---|---|
| Services billed | 1,154 across 11 procedure codes |
| Paid by Medicare | $89,595 |
Other Pharmacy providers in Grand Rapids
- 1801320197
- 1992037105