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CUB PHARMACY #1587
NPI 1942831839
Pharmacy - Community/Retail Pharmacy in Minneapolis, MN

Active since January 29, 2020CLIA 24D2179334 · Waiver
4601 SNELLING AVE, MINNEAPOLIS, MN 55406(612) 886-3393(612) 886-3850 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 7, 2023, Jun 4, 2020, Feb 26, 2020 and 1 more (4 updates tracked since 2020).

About Cub Pharmacy #1587 NPPES

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

CUB PHARMACY #1587 (NPI 1942831839) is a healthcare organization registered as a community/retail pharmacy in Minneapolis, Minnesota and active in the NPI registry since January 2020. The organization holds a CLIA Waiver certificate valid through February 19, 2028 and lists Jessica O'connell, Manager, Managed Care, as its authorized official.

NPPES Registry Identity

NPI1942831839
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSUPERVALU PHARMACIES INC
Location Address4601 SNELLING AVEMinneapolis, MN 55406-4464
Mailing Address421 3rd St SStillwater, MN 55082-4955 · (651) 779-4023 · Fax (651) 779-2023
Phone(612) 886-3393
Fax(612) 886-3850
Organization SubpartNo
Authorized OfficialJessica O'connellManager, Managed Care · (651) 779-4023
Enumeration DateJanuary 29, 2020
Last NPPES UpdateMarch 7, 20234 updates tracked since enumeration
NPPES CertifiedJune 4, 2020
✔ NPI 1942831839 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
4601 SNELLING AVE, Minneapolis, MN 55406
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Other Names 1

Doing Business AsCub Pharmacy #1587

Other Identifiers 3

Other266013MN · Pharmacy State License
Other0326790253Medicare Nsc
Other2434784Ncpdp

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 24D2179334

Cub Pharmacy #1587 · Minneapolis, MN
Active · expires Feb 19, 2028
CLIA Number24D2179334
Laboratory TypePharmacy
Certificate Effective DateFebruary 20, 2026
Certificate Expiration DateFebruary 19, 2028
Laboratory DirectorKristin Reddall
Laboratory Phone(612) 886-3393
Laboratory LocationCub Pharmacy #15874601 Snelling Avenue South, Minneapolis, MN 55406
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier Medicare DMEPOS 16

Medicare supplier enrollment and the product categories Cub Pharmacy #1587 carries, from the Medicare DMEPOS supplier directory.

Cub Pharmacy #1587

DMEPOS supplier · Minneapolis, MNOperated by Supervalu Pharmacies Inc
⋮

Does not accept Medicare assignment

Cub Pharmacy #1587 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)20570513
Medicare Participant SinceJanuary 1, 2007
Supplier Location4601 Snelling AveMinneapolis, MN 55406
Phone(612) 886-3393
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 2

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

DAWN SCHOLBROCK
Pharmacist
4601 SNELLING AVE
MINNEAPOLIS, MN 55406
Hennepin County (612) 886-3393
RYAN LARSON
Pharmacist
4601 SNELLING AVE
MINNEAPOLIS, MN 55406
Hennepin County (612) 886-3393

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 1942831839. It was assigned to this organization in the NPPES registry on January 29, 2020. The provider is doing business as Cub Pharmacy #1587.

Where is Supervalu Pharmacies Inc located?

Supervalu Pharmacies Inc is located at 4601 Snelling Ave, Minneapolis, MN 55406. The listed phone number is (612) 886-3393.

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 #1587 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.

Does Supervalu Pharmacies Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2179334) is associated with this NPI, valid through February 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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 Arizona Complete Health and 48 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 March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.