Organization
COBORNS INC
Active
Other names
COBORN'S PHARMACY #2027, COBORNS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JIM COX RPH (DIRECTOR OF PHARMACY)
(320) 251-5505
Entity
Organization
Contact information
Practice address
2211 11TH ST E, GLENCOE, MN 55336-2629
(320) 864-5192
(320) 864-2767
Mailing address
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
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
262764
MN
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881632123
—
MN
01
—
2049092
PK
—
Enumeration date
06/02/2006
Last updated
08/21/2020
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