Healthcare Provider Details

I. General information

NPI: 1811501356
Provider Name (Legal Business Name): COBORNS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2020
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 1ST ST S
SAUK RAPIDS MN
56379-1453
US

IV. Provider business mailing address

PO BOX 6146
SAINT CLOUD MN
56302-6146
US

V. Phone/Fax

Practice location:
  • Phone: 800-548-2568
  • Fax: 855-456-8162
Mailing address:
  • Phone: 320-251-5505
  • Fax: 320-203-1095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336M0002X
TaxonomyMail Order Pharmacy
License Number
License Number State

VIII. Authorized Official

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