Healthcare Provider Details

I. General information

NPI: 1952623076
Provider Name (Legal Business Name): COBORNS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2010
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 4TH ST SE
SAINT CLOUD MN
56304-1297
US

IV. Provider business mailing address

PO BOX 6146 PO BOX 6146
SAINT CLOUD MN
56302-6146
US

V. Phone/Fax

Practice location:
  • Phone: 320-258-0155
  • Fax: 320-258-0152
Mailing address:
  • Phone: 320-251-5505
  • Fax: 320-203-1095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number263471
License Number StateMN
# 5
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: REBECCA PICKLER
Title or Position: DIREECTOR OF PHARMACY
Credential: PHARMD
Phone: 320-251-5505