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CVS PHARMACY # 05920
NPI 1003118696
Pharmacy in St. Michael, MN

Active since December 02, 2010CLIA Certified · 18 labs
600 CENTRAL AVE. E, ST. MICHAEL, MN 55376(763) 497-6632(401) 770-7108 Get Directions Write a Review

NPPES record last updated: July 11, 2011. Verified against the NPPES registry weekly; last sync: September 20, 2026.

About Cvs Pharmacy # 05920 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CVS PHARMACY # 05920 (NPI 1003118696) is a healthcare organization registered as a pharmacy in St. Michael, Minnesota and active in the NPI registry since December 2010. The organization holds 18 active CLIA laboratory certificates and lists Susan Colbert, Director, Payer Relations, as its authorized official.

NPPES Registry Identity

NPI1003118696
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameGRAND ST. PAUL CVS, L.L.C.
Location Address600 CENTRAL AVE. ESt. Michael, MN 55376-4584
Mailing Address1 Cvs DrWoonsocket, RI 02895-6146 · (401) 765-1500 · Fax (401) 770-7108
Phone(763) 497-6632
Fax(401) 770-7108
Organization SubpartNo
Authorized OfficialSusan ColbertDirector, Payer Relations · (401) 765-1500
Enumeration DateDecember 2, 2010
Last NPPES UpdateJuly 11, 2011
✔ NPI 1003118696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
Definition
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacy · Community/Retail PharmacyTaxonomy 3336C0003X
600 CENTRAL AVE. E, St. Michael, MN 55376
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Other Names 1

Doing Business AsCvs Pharmacy # 05920

Other Identifiers 4

Medicare NSC5603920048MN
Medicare PIN730000099MN
Other2430469MN · Ncpdp
Medicaid1003118696MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA 18

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2232532

CVS Pharmacy, Inc Dba Cvs/Pharmacy #11091 · Argyle, TX
Active · expires Aug 14, 2027
CLIA Number45D2232532
Laboratory TypePharmacy
Certificate Effective DateAugust 15, 2025
Certificate Expiration DateAugust 14, 2027
Laboratory DirectorEkwere Ekpo
Laboratory Phone(401) 765-1500
Laboratory LocationCVS Pharmacy, Inc Dba Cvs/Pharmacy #11091111 Fm 407 W, Argyle, TX 76226
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2227824

Holiday CVS LLC Dba CVS Pharmacy #5439 · Melbourne, FL
Active · expires Jun 16, 2027
CLIA Number10D2227824
Laboratory TypePharmacy
Certificate Effective DateJune 17, 2025
Certificate Expiration DateJune 16, 2027
Laboratory DirectorSara Shipley
Laboratory Phone(401) 765-1500
Laboratory LocationHoliday CVS LLC Dba CVS Pharmacy #543915 E New Haven Ave, Melbourne, FL 32901
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2227494

Holiday CVS, LLC Dba Cvs/ Pharmacy #4989 · Palm Beach Gardens, FL
Active · expires Jun 13, 2027
CLIA Number10D2227494
Laboratory TypePharmacy
Certificate Effective DateJune 14, 2025
Certificate Expiration DateJune 13, 2027
Laboratory DirectorBassem Metry
Laboratory Phone(401) 765-1500
Laboratory LocationHoliday CVS, LLC Dba Cvs/ Pharmacy #49894500 Donald Ross Rd, Palm Beach Gardens, FL 33418
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2227529

Holiday CVS LLC Dba Cvs/Pharmacy #5115 · Davie, FL
Active · expires Jun 13, 2027
CLIA Number10D2227529
Laboratory TypePharmacy
Certificate Effective DateJune 14, 2025
Certificate Expiration DateJune 13, 2027
Laboratory DirectorTaposi Rabeya
Laboratory Phone(401) 765-1500
Laboratory LocationHoliday CVS LLC Dba Cvs/Pharmacy #51152920 Davie Rd, Davie, FL 33314
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2227550

Holiday CVS LLC Dba Cvs/Pharmacy #5145 · Miami Gardens, FL
Active · expires Jun 13, 2027
CLIA Number10D2227550
Laboratory TypePharmacy
Certificate Effective DateJune 14, 2025
Certificate Expiration DateJune 13, 2027
Laboratory DirectorJanay Scott
Laboratory Phone(401) 765-1500
Laboratory LocationHoliday CVS LLC Dba Cvs/Pharmacy #51454700 NW 183rd St, Miami Gardens, FL 33055
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2227426

Holiday CVS, LLC Dba Cvs/Pharmacy #3765 · Miami, FL
Active · expires Jun 10, 2027
CLIA Number10D2227426
Laboratory TypePharmacy
Certificate Effective DateJune 11, 2025
Certificate Expiration DateJune 10, 2027
Laboratory DirectorJames Mccall
Laboratory Phone(401) 765-1500
Laboratory LocationHoliday CVS, LLC Dba Cvs/Pharmacy #376519198 S Dixie Hwy, Miami, FL 33157
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
134 services134 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
96 services96 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
32 services32 patients

Medical Equipment Supplier Medicare DMEPOS 19

Medicare supplier enrollment and the product categories CVS Pharmacy #16954 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #16954

DMEPOS supplier · Savage, MNOperated by Grand St Paul CVS LLC
✔

Accepts Medicare assignment

CVS Pharmacy #16954 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20331425
Medicare Participant SinceJanuary 1, 2023
Supplier Location14333 Hwy 13 SSavage, MN 55378
Phone(952) 226-1442
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Commodes, Urinals, Bedpans
Raised toilets, Drop-arm commodes, Folding commodes, Plastic urinals, Plastic bedpans, Disposable urinals
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grand St. Paul CVS, L.L.C.'s NPI number?

The NPI number for Grand St. Paul CVS, L.L.C. is 1003118696. It was assigned to this organization in the NPPES registry on December 2, 2010. The provider is doing business as CVS Pharmacy # 05920.

Where is Grand St. Paul CVS, L.L.C. located?

Grand St. Paul CVS, L.L.C. is located at 600 Central Ave. E, St. Michael, MN 55376. The listed phone number is (763) 497-6632.

What is Grand St. Paul CVS, L.L.C.'s specialty?

The primary specialty registered for this NPI is Pharmacy with taxonomy code 333600000X.

Does Grand St. Paul CVS, L.L.C. accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, CVS Pharmacy #16954 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Grand St. Paul CVS, L.L.C. hold CLIA laboratory certificates?

Yes. 18 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Grand St. Paul CVS, L.L.C. accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 32 other insurers list Grand St. Paul CVS, L.L.C. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Grand St. Paul CVS, L.L.C. was last updated on July 11, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.