Organization
COBORNS INC
Active
Parent organization
COBORNS INC
Other names
COBORN'S PHARMACY SERVICES #1702, COBORNS PHARMACY SERVICES
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
110 1ST ST S STE B, SAUK RAPIDS, MN 56379-1404
(877) 251-5543
(800) 893-4666
Mailing address
PO BOX 6146, SAINT CLOUD, MN 56302-6146
(320) 534-2745
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
265384
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1797279608
NPI
—
01
—
2433580
NCPDP
—
01
—
265384
STATE PHARMACY LICENSE
MN
Enumeration date
07/29/2017
Last updated
08/21/2020
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