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Coborns Inc

Organization Active NPI Community/Retail Pharmacy · Hastings, MN

NPI 1447447644 · NPPES record last updated Aug 21, 2020

Key facts

NPI
1447447644
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
263092 (MN)
Legal business name
COBORNS INC
Practice address
225 33Rd St W
Hastings, MN 55033-4512
Phone
(888) 438-6717
Fax
(855) 458-0493
NPI assigned
Oct 2, 2007
Organization subpart
Yes
Parent organization (as reported)
COBORNS INC

Authorized official

Name
Lynn R Young, RPH
Title
Director of Pharmacy
Phone
(320) 354-2743

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Other NPIs on the same Medicare enrollment 34

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 34

Corporate family (same tax ID) 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Coborn'S Pharmacy #2037
225 33Rd St W, Hastings, MN 55033-4512 · (651) 437-6716		 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order)|Orthoses: Off-The-Shelf|Ostomy Supplies|Urological Supplies|Nebulizer Equipment and/or Supplies|Surgical Dressings Accepts assignment
Participating since Jan 1, 2016

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20071215000009 MN Part B Supplier - Mass Immunization (Roster Biller Only) 3072416593 35 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Ulm, MN; Princeton, MN; Otsego, MN; Owatonna, MN; Park Rapids, MN; Pipestone, MN; Ramsey, MN; Saint Cloud, MN…
O20100930033521 MN DME Supplier - Pharmacy
DME Supplier - Grocery Store		 3072416593 Practice locations: Hastings, MN

National Provider Directory

Tax ID family
Coborn'S Pharmacy Service (38 organizations share this tax ID)
Part of
Coborn'S Pharmacy Service

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 263092 MN Yes
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

225 33Rd St W
Hastings, MN 55033-4512

Mailing address

PO Box 6146
PO Box 6146
Saint Cloud, MN 56302
Phone (320) 534-2745

Other identifiers

IdentifierTypeStateIssuer
2049331OtherPK
1447447644MedicaidMN

Other names

  • COBORNS PHARMACY #2037 Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 21, 2020.

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597968000000",
    "number": "1447447644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6146",
            "address_2": "PO BOX 6146",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "56302",
            "telephone_number": "320-534-2745",
            "fax_number": "320-203-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 33RD ST W",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550334512",
            "telephone_number": "888-438-6717",
            "fax_number": "855-458-0493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBORNS INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COBORNS INC",
        "enumeration_date": "2007-10-02",
        "last_updated": "2020-08-21",
        "certification_date": "2020-08-21",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "320-354-2743",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MN",
            "license": "263092",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2049331",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447447644",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COBORNS PHARMACY #2037",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hastings, MN

All providers in Hastings, MN · Community/Retail Pharmacy in Minnesota

Sources for this page

Verify at the official NPI Registry.