Organization
COBORNS INC
Active
Parent organization
COBORNS INC
Other names
Coborn's Pharmacy #2042
Organization subpart
Yes
Provider details
NPI number
Legal business name
COBORNS INC
Authorized official
LYNN R YOUNG RPH (DIRECTOR OF PHARMACY)
(320) 534-2743
Entity
Organization
Contact information
Practice address
1010 ENTERPRISE DR E, BELLE PLAINE, MN 56011-2340
(877) 503-2605
(855) 459-1538
Mailing address
PO BOX 6146, PO BOX 6146, SAINT CLOUD, MN 56302-6146
(320) 534-2745
(320) 203-1095
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
263605
MN
333600000X
Pharmacy
PHAR1184
ND
3336C0003X
Community/Retail Pharmacy
Primary
054016420
IL
3336C0004X
Compounding Pharmacy
1017-43
WI
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154622991
—
MN
01
—
2127379
PK
—
Enumeration date
11/10/2010
Last updated
08/21/2020
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