# COBORNS INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COBORNS INC
- **Other names:** MARKETPLACE PHARMACY \#2583
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1003260969
- **Legal business name:** COBORNS INC
- **Authorized official:** CHAD NELLIS PHARMD (DIRECTOR OF PHARMACY)
- **Authorized official phone:** (320) 534-2743

## Contact information

- **Practice address:** 10514 MAIN ST, HAYWARD, WI 54843-6720
- **Practice address phone:** (715) 634-1817
- **Practice address fax:** (855) 304-4787
- **Mailing address:** PO BOX 6146, PHARMACY OFFICE, SAINT CLOUD, MN 56302-6146
- **Mailing address phone:** (320) 534-2744
- **Mailing address fax:** (320) 203-1095

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 9403-42 | WI | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 04/18/2016
- **Last updated:** 07/23/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1000056023 | — | WI |
| 01 | — | 2159610 | PK | — |