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General NPI Number Information
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NPI Number | 1639966286
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Entity Type | Organization
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Legal Business Name | COBORNS INC
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 621 6TH AVE SE
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City | ABERDEEN
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State | SD
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Zip | 57401-4538
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Country | US
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Telephone | 605-225-6673
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Fax | 605-225-1612
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Provider Business Mailing Address
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Address Line | 1921 COBORN BLVD
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City | SAINT CLOUD
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State | MN
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Zip | 56301-2100
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Country | US
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Telephone | 320-534-2744
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Fax |
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Authorized Official
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Title or Position | SENIOR DIRECTOR OF PHARMACY
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Name | CHAD NELLIS
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Credential | PHARM D
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Telephone | 320-534-2743
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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