MEDICARE: COBORNS INC

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	3336L0003X	Long Term Care Pharmacy
2	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1902480650
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COBORNS INC

Provider Business Mailing Address
First Line	:	PO BOX 6146
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56302-6146
Country	:	US
Telephone Number	:	320-251-5505
Fax Number	:	320-203-1095

Provider Business Practice Location Address
First Line	:	630 RYANS WAY
Second Line	:
City	:	BUFFALO
State	:	MN
Zip	:	55313-4527
Country	:	US
Telephone Number	:	763-330-0900
Fax Number	:	855-302-4734

Authorized Official
Title or Position	:	DIRECTOR OF PHARMACY
Name	:	REBECCA PICKLER
Credential	:
Telephone Number	:	320-251-5505

Provider Enumeration Date	:	05/10/2021
Last Update Date	:	12/08/2025

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Directions to “COBORNS INC ” Practice Location

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