Healthcare Provider Details

I. General information

NPI: 1326823766
Provider Name (Legal Business Name): COBORNS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2023
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

1921 COBORN BLVD
SAINT CLOUD MN
56301-2100
US

V. Phone/Fax

Practice location:
  • Phone: 320-258-7111
  • Fax: 833-612-1246
Mailing address:
  • Phone: 320-251-5505
  • Fax: 320-203-1095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

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