| NPI | 1003921149 |
|---|---|
| NPI Type | NPI-2 Organization |
| Status | Active |
| Enumeration Date | 2006-08-20 |
| Last Updated | 2023-06-28 |
| Authorized Official | Steve Mccann VP Pharmacy Phone: 9528284531 |
| Mailing Address | 11840 Valley View Rd Eden Prairie, MN 55344-3643 United States Phone: (952) 828-4588 | Fax: (952) 947-3470 📍 View Map |
| Primary Practice Address | 1021 15th Ave Se Rochester, MN 55904 United States Phone: (507) 288-3234 | Fax: (507) 288-8977 📍 View Map |
| Issuer | State | Number | Other Issuer |
|---|---|---|---|
| Other (non-Medicare) | — | 2048203 | PK |
| Other (non-Medicare) | — | 2424137 | NCPDP |
| MEDICAID | MN | 490610100 | — |
| Primary | Taxonomy Code & Description | State | License Number |
|---|---|---|---|
| No | 332B00000X – Durable Medical Equipment & Medical Supplies | — | — |
| No | 333600000X – Pharmacy | — | — |
| Yes | 3336C0003X – Pharmacy, Community/Retail Pharmacy | MN | 261996 |
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About NPI 1003921149
Supervalu Pharmacies Inc is an organization registered in the CMS NPPES NPI Registry with NPI number 1003921149. The primary specialty listed is Pharmacy, Community/Retail Pharmacy. The organization is located in Rochester, MN. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2006-08-20. All data is sourced directly from the official CMS NPPES public API and is updated daily.
Frequently Asked Questions
What is NPI 1003921149?
NPI 1003921149 belongs to Supervalu Pharmacies Inc, a Pharmacy, Community/Retail Pharmacy in Rochester, MN. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.
Is NPI 1003921149 active?
The current status of NPI 1003921149 in the NPPES registry is Active. The record was last updated on 2023-06-28.
What specialty is NPI 1003921149?
NPI 1003921149 is classified under the taxonomy Pharmacy, Community/Retail Pharmacy. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.
How do I verify NPI 1003921149?
You can verify NPI 1003921149 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.
What address is on file for NPI 1003921149?
The primary practice address on file for NPI 1003921149 is 1021 15th Ave Se, Rochester, MN 55904. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.
When was NPI 1003921149 issued?
NPI 1003921149 was first issued (enumerated) on 2006-08-20. The NPPES record was last updated on 2023-06-28.
Practice Location Map
Supervalu Pharmacies Inc is located at 1021 15th Ave Se, Rochester, MN. Use the map below to find directions or verify the practice location.
Related Healthcare Providers
The following providers share the same practice location, specialty, or state as Supervalu Pharmacies Inc. All records sourced from the CMS NPPES registry.
License Information
The following state license numbers are on file in the NPPES registry for NPI 1003921149. For license status verification, contact the relevant state licensing board directly.
| Specialty / Taxonomy | License Number | State |
|---|---|---|
| Pharmacy, Community/Retail Pharmacy | 261996 | MN |