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CVS PHARMACY # 00241
NPI 1770770828
Pharmacy in Farmington, MN

Active since October 02, 2007CLIA 24D2279550 · Waiver
19605 PILOT KNOB RD., FARMINGTON, MN 55024(651) 463-3693 Get Directions Write a Review

NPPES record last updated: November 18, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Cvs Pharmacy # 00241 NPPES

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

CVS PHARMACY # 00241 (NPI 1770770828) is a healthcare organization registered as a pharmacy in Farmington, Minnesota and active in the NPI registry since October 2007. The organization holds a CLIA Waiver certificate valid through April 3, 2027 and lists Susan Colbert, Director, Payer Relations, as its authorized official.

NPPES Registry Identity

NPI1770770828
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameGRAND ST PAUL CVS LLC
Location Address19605 PILOT KNOB RD.Farmington, MN 55024
Mailing Address1 Cvs Dr, Box 1075 - Pharmacy EnrollmentsWoonsocket, RI 02895-6146 · (401) 765-1500 · Fax (401) 770-7108
Phone(651) 463-3693
Organization SubpartNo
Authorized OfficialSusan ColbertDirector, Payer Relations · (401) 770-2751
Enumeration DateOctober 2, 2007
Last NPPES UpdateNovember 18, 2010
✔ NPI 1770770828 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
19605 PILOT KNOB RD., Farmington, MN 55024
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Other Names 1

Doing Business AsCvs Pharmacy # 00241

Other Identifiers 4

Medicare PIN730000099
Medicare NSC5603920011MN
Medicaid529160100MN
Other2428488MN · Commercial Number

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

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 24D2279550

Grand St Paul CVS, LLC Dba Cvs/Pharmacy #00241 · Farmington, MN
Active · expires Apr 3, 2027
CLIA Number24D2279550
Laboratory TypePharmacy
Certificate Effective DateApril 4, 2025
Certificate Expiration DateApril 3, 2027
Laboratory DirectorMinh Khoa Nguyen
Laboratory Phone(651) 463-3693
Laboratory LocationGrand St Paul CVS, LLC Dba Cvs/Pharmacy #0024119605 Pilot Knob Rd, Farmington, MN 55024
CLIA data matches this NPI record on: Address Name 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.
155 services153 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.
121 services121 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.
20 services20 patients

Medical Equipment Supplier Medicare DMEPOS 19

Medicare supplier enrollment and the product categories CVS Pharmacy #00241 carries, from the Medicare DMEPOS supplier directory.

CVS Pharmacy #00241

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

Accepts Medicare assignment

CVS Pharmacy #00241 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)20330117
Medicare Participant SinceJanuary 1, 2023
Supplier Location19605 Pilot Knob RdFarmington, MN 55024
Phone(651) 463-3693
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 LLC's NPI number?

The NPI number for Grand St Paul CVS LLC is 1770770828. It was assigned to this organization in the NPPES registry on October 2, 2007. The provider is doing business as CVS Pharmacy # 00241.

Where is Grand St Paul CVS LLC located?

Grand St Paul CVS LLC is located at 19605 Pilot Knob Rd., Farmington, MN 55024. The listed phone number is (651) 463-3693.

What is Grand St Paul CVS LLC's specialty?

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

Does Grand St Paul CVS LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, CVS Pharmacy #00241 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Grand St Paul CVS LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2279550) is associated with this NPI, valid through April 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Grand St Paul CVS LLC 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 33 other insurers list Grand St Paul CVS LLC 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 LLC was last updated on November 18, 2010. 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.