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COBORNS INC NPI 1417480633


NPI Information

NPI: 1417480633
Provider Name: COBORNS INC

Doing Business As: COBORN'S LTC PHARMACY #2006

Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

CLIA Number: 24D2033664

Address:
1105 2ND AVE NE
LITTLE FALLS, MN
ZIP 56345
Phone: (320) 632-2380
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COBORNS INC is a long term care pharmacy pharmacy in Little Falls, MN. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. COBORNS INC NPI is 1417480633. The provider is registered as an organization entity type.
The provider Is Doing Business As Coborn's Ltc Pharmacy #2006.

The provider's business location address is:

1105 2ND AVE NE
LITTLE FALLS, MN
ZIP 56345-943
Phone: (320) 632-2380
Fax: (320) 632-3079

The provider's authorized official is Chad Nellis .
The authorized official title is Director Of Pharmacy and has the following contact phone number (320) 534-2743.

The CLIA number assigned to this NPI record is 24D2033664 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/5/2017 and was last updated on 9/20/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336L0003XPharmacyLong Term Care PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12434760OTHERNCPDP LTC
2261254OTHERMINNESOTAPHARMACY LICENSE
31417480633OTHERNPI LTC
41760555304MEDICAIDMINNESOTA
51417480633MEDICAIDMINNESOTA
6BC4361503OTHERMINNESOTADEA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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