CVS PHARMACY #17387
NPI 1316131204
Pharmacy in Rochester, MN

Q: What is Grand St Paul CVS LLC's NPI number?

The NPI number for Grand St Paul CVS LLC is 1316131204. It was assigned to this organization in the NPPES registry on September 4, 2007. The provider is doing business as CVS Pharmacy #17387.

Q: What is Grand St Paul CVS LLC's specialty?

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

Active since September 04, 2007

4611 MAINE AVE SE, ROCHESTER, MN 55904(507) 206-5021(507) 206-5031 Get Directions Write a Review

NPPES record last updated: November 21, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 21, 2016, Jan 11, 2016 (2 updates tracked since 2016).

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About Cvs Pharmacy #17387 NPPES

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

CVS PHARMACY #17387 (NPI 1316131204) is a healthcare organization registered as a pharmacy in Rochester, Minnesota and active in the NPI registry since September 2007. The organization lists Susan Colbert, Sr. Director, Payer Relations, as its authorized official.

NPPES Registry Identity

NPI1316131204

Entity TypeOrganization

Primary Taxonomy333600000X

Legal Business NameGRAND ST PAUL CVS LLC

Location Address4611 MAINE AVE SERochester, MN 55904-6929

Mailing Address1 Cvs Dr, Mail Code 1090Woonsocket, RI 02895-6146 · (401) 765-1500

Phone(507) 206-5021

Fax(507) 206-5031

Organization SubpartNo

Authorized OfficialSusan ColbertSr. Director, Payer Relations · (401) 770-2751

Enumeration DateSeptember 4, 2007

Last NPPES UpdateNovember 21, 20162 updates tracked since enumeration

✔ NPI 1316131204 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 · License 263090 (MN)

4611 MAINE AVE SE, Rochester, MN 55904

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Other Names 1

Doing Business AsCvs Pharmacy #17387

Other Identifiers 4

Other2049327Pk

Medicaid891938000MN

Medicare NSC0640711385

Medicare NSC5603920079

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 ›

Areas of Expertise CMS Part B claims 6

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.

190 services190 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.

137 services137 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.

45 services45 patients

Severe acute respiratory syndrome coronavirus 2 (covid-19) vaccine, recombinant spike protein nanoparticle, saponin-based adjuvant, preservative free, 5 mcg/0.5ml dosage, for intramuscular use 91304

The COVID-19 vaccine you'll receive is designed to protect against the virus. It contains tiny, harmless pieces of the virus's spike protein. These trigger your immune system to build a defense. The vaccine also includes a saponin-based adjuvant to enhance this response. It's given as a 0.5ml injection into a muscle.

12 services12 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

11 services11 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

11 services11 patients

Medical Equipment Supplier Medicare DMEPOS 19

Medicare supplier enrollment and the product categories CVS Pharmacy #17387 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #17387

DMEPOS supplier · Rochester, MNOperated by Grand St Paul CVS LLC

✔

Accepts Medicare assignment

CVS Pharmacy #17387 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)20331521

Medicare Participant SinceJanuary 1, 2023

Supplier Location4611 Maine Ave SERochester, MN 55904

Phone(507) 206-5021

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.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REGINA HAEFLINGER PHARMD

Pharmacist