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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

SUPERVALU PHARMACIES INC
NPI 1598176117
Pharmacy - Community/Retail Pharmacy in Minneapolis, MN

Active since May 16, 2014
1104 LAGOON AVE, MINNEAPOLIS, MN 55408(612) 825-1992(612) 825-1996 Get Directions Write a Review

NPPES record last updated: October 23, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Supervalu Pharmacies Inc NPPES

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

SUPERVALU PHARMACIES INC (NPI 1598176117), doing business as Cub Pharmacy, is a healthcare organization registered as a community/retail pharmacy in Minneapolis, Minnesota and active in the NPI registry since May 2014. The organization lists Jessica O'connell, Sr Manager, Managed Care, as its authorized official.

NPPES Registry Identity

NPI1598176117
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSUPERVALU PHARMACIES INC
Location Address1104 LAGOON AVEMinneapolis, MN 55408-2059
Mailing AddressPo Box 990Minneapolis, MN 55440-0990 · (651) 779-4023
Phone(612) 825-1992
Fax(612) 825-1996
Organization SubpartNo
Authorized OfficialJessica O'connellSr Manager, Managed Care · (651) 779-4023
Enumeration DateMay 16, 2014
Last NPPES UpdateOctober 23, 2026
NPPES CertifiedOctober 23, 2026
✔ NPI 1598176117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in MN · 264446
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
1104 LAGOON AVE, Minneapolis, MN 55408
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Other Names 1

Doing Business AsCub Pharmacy

Other Identifiers 2

Medicaid1598176117MN
Other2146376Pk

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 Arkansas Health & Wellness and more.Insurance ›

Medical Equipment Supplier Medicare DMEPOS 16

Medicare supplier enrollment and the product categories Cub Pharmacy #1693 carries, from the Medicare DMEPOS supplier directory.

Cub Pharmacy #1693

DMEPOS supplier · Minneapolis, MNOperated by Supervalu Pharmacies Inc
⋮

Does not accept Medicare assignment

Cub Pharmacy #1693 has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20569775
Medicare Participant SinceJanuary 1, 2007
Supplier Location1104 Lagoon AveMinneapolis, MN 55408
Phone(612) 821-0547
Supplier Specialties
Pharmacy Grocery Store

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
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
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 5

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

ANNA SKUBAL
Pharmacist
1104 LAGOON AVE
MINNEAPOLIS, MN 55408
Hennepin County (612) 825-1992
RBF LLC
Pharmacy (Community/Retail Pharmacy)
1104 LAGOON AVE
MINNEAPOLIS, MN 55408
Hennepin County (612) 821-0547
NHAT THINH VO PHARMD
Pharmacist
1104 LAGOON AVE
MINNEAPOLIS, MN 55408
Hennepin County (612) 825-1992
MR. DEEQ MOHAMMED PHARM D
Pharmacist
1104 LAGOON AVE
MINNEAPOLIS, MN 55408
Hennepin County (612) 825-1992
MEGHAN KAY KIRCHHOFF PHARMD
Pharmacist
1104 LAGOON AVE
MINNEAPOLIS, MN 55408
Hennepin County (612) 825-1992

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 Supervalu Pharmacies Inc's NPI number?

The NPI number for Supervalu Pharmacies Inc is 1598176117. It was assigned to this organization in the NPPES registry on May 16, 2014. The provider is doing business as Cub Pharmacy.

Where is Supervalu Pharmacies Inc located?

Supervalu Pharmacies Inc is located at 1104 Lagoon Ave, Minneapolis, MN 55408. The listed phone number is (612) 825-1992.

What is Supervalu Pharmacies Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Supervalu Pharmacies Inc accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Cub Pharmacy #1693 does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

What insurance does Supervalu Pharmacies Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 45 other insurers list Supervalu Pharmacies Inc 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 Supervalu Pharmacies Inc was last updated on October 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 days 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.