MEDICARE: MOBE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy

General Provider Information

NPI Number	:	1063355485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBE, LLC

Provider Business Mailing Address
First Line	:	3701 WAYZATA BLVD STE 450
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55416-0018
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3701 WAYZATA BLVD STE 450
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55416-0018
Country	:	US
Telephone Number	:	800-425-6614
Fax Number	:

Authorized Official
Title or Position	:	SVP, CLINICAL & HEALTH OUTCOMES
Name	:	LESLIE HELOU
Credential	:	PHARMD
Telephone Number	:	612-504-1742

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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