Organization · Type 2 NPI

Supervalu Pharmacies Inc

Community/Retail Pharmacy · St. Michael, MN

NPI number 1780213587 Active

Practice location

900 Central Ave E
St. Michael, MN 55376-4594

Call (763) 497-3568 Map

Fax (763) 497-3605

Mailing address

PO Box 990
Minneapolis, MN 55440-0990

Specialties and licenses

Taxonomy	Code	License
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	None listed

Community/Retail Pharmacy: 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 …

3 other providers at this address

NPI record

NPI: 1780213587
Entity type: Organization (Type 2)
Issued: Apr 3, 2020
Last updated: Oct 23, 2026
Status: Active

Other names

<unavail>
Cub Pharmacy #1965 · doing business as
Cub Pharmacy #1965 · doing business as

Authorized official

Jessica O'Connell
SR Manager, Managed Care
(651) 779-4023

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1780213587

Supervalu Pharmacies Inc's National Provider Identifier is 1780213587, issued on Apr 3, 2020. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in St. Michael, MN. The record was last updated on Oct 23, 2026.