Coborns Inc
Organization Active NPI Community/Retail Pharmacy · Foley, MN
NPI 1932272572 · NPPES record last updated Aug 21, 2020
Key facts
- NPI
- 1932272572
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 261544 (MN)
- Legal business name
- COBORNS INC
- Practice address
- 161 Glen St
Foley, MN 56329 - Phone
- (888) 316-8625
- Fax
- (855) 456-8163
- NPI assigned
- Nov 15, 2006
- 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
Other NPIs on the same Medicare enrollment 34
Corporate family (same tax ID) 37
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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… |
| O20100930037614 | MN | DME Supplier - Pharmacy |
3072416593 | Practice locations: Foley, MN |
National Provider Directory
- Tax ID family
- Coborn'S Pharmacy Service
- Part of
- Coborn'S Pharmacy Service
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | |||
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 261544 | MN | Yes |
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
161 Glen St
Foley, MN 56329
Mailing address
PO Box 6146
PO Box 6146
Saint Cloud, MN 56302-6146
Phone (320) 534-2745
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932272572 | Medicaid | MN | |
| 2047853 | Other | PK |
Other names
- COBORNS PHARMACY #2002
Other providers in Foley, MN
- Mischelle Blenkush
- Derrick Steven Breeden
- Jason Brule
- Centracare Clinic
- Centracare Clinic
- County of Benton Ind School Dist 51
- Dean T Weber
- Dewey Street Dental
- Brooke Lynne Doerscher
- Stephanie Anne O'Brien Driessen
All providers in Foley, MN · Community/Retail Pharmacy in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.