COBORN'S CLINIC PHARMACY # 2017
NPI 1194101766
Health Maintenance Organization in Mora, MN

NPI Status: Active since August 06, 2015

Contact Information

710 FRANKIE LN
MORA, MN
ZIP 55051
Phone: (320) 679-2363
Fax: (320) 679-1620

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  • Organization
  • Health Maintenance Organization
  • Medicare Supplier
  • Accepts Medicare Approved Payment
  • CLIA Number: 24D2173502
  • CLIA Cert. Type: Pharmacy
  • CLIA Exp. Date: 10-14-2027

About COBORN'S CLINIC PHARMACY # 2017

This page provides the complete NPI Profile along with additional information for Coborn's Clinic Pharmacy # 2017, a provider established in Mora, Minnesota operating as a Health Maintenance Organization. The healthcare provider is registered in the NPI registry with number 1194101766 assigned on August 2015. The practitioner's primary taxonomy code is 302R00000X with license number 119447 (MN). The provider is registered as an organization and their NPI record was last updated 6 years ago. The provider's is doing business as Coborn's Clinic Pharmacy # 2017. The authorized official of this NPI record is Ms. Lynn R Young Rph (Director Of Pharmacy)

NPI
1194101766
Provider Legal Name
COBORNS INC
Other Organization Name
COBORN'S CLINIC PHARMACY # 2017
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
710 FRANKIE LN MORA, MN 55051
Location Phone
(320) 679-2363
Location Fax
(320) 679-1620
Mailing Address
PO BOX 6146 SAINT CLOUD, MN 56302
Mailing Phone
(320) 534-2745
Mailing Fax
(320) 679-1620
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
08-06-2015
Last Update Date
08-21-2020
Code Navigator



Coborn's Clinic Pharmacy # 2017 is a medicare supplier with PTAN 20480945 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Epoetin or Immunosuppressive Drugs or Infusion Drugs or Nebulizer Drugs or Oral Anticancer Drugs or Oral Antiemetic Drugs or Blood Glucose Monitors/Supplies (Non-Mail Order) or Canes and/or Crutches or Orthoses: Off-The-Shelf or Ostomy Supplies or Urological Supplies or Nebulizer Equipment and/or Supplies or Surgical Dressings.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Health Maintenance Organization

Taxonomy Code
302R00000X
Type
Managed Care Organizations
License No.
119447
License State
MN
Taxonomy Description
(1) A form of health insurance in which its members prepay a premium for the HMO's health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
13336C0003XSuppliers

Pharmacy
Community/Retail Pharmacy

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MS. LYNN R YOUNG RPH

Authorized Official Title
DIRECTOR OF PHARMACY
Authorized Official Phone
(320) 534-2743

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
2406987OTHER (01)NCPDP
1831261502MEDICAID (05)MN 

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20480945
Accepts Medicare Assignment
YES
Specialities List
Pharmacy.
Competitive Bidding
NO

Supplies List

  • Epoetin - Epoetin is a man-made version of human erythropoietin (EPO)
  • Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
  • Infusion Drugs -
  • Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
  • Oral Anticancer Drugs - FDA anticancer drugs
  • Oral Antiemetic Drugs - FDA antiemetic drugs
  • Blood Glucose Monitors/Supplies (Non-Mail Order) - Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
  • Canes and/or Crutches - Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
  • Orthoses: Off-The-Shelf - Met pads, Heel pads, Heel spur pads
  • Ostomy Supplies - Pouches, Paste, Powder, Barrier wipes
  • Urological Supplies - Catheters, Urinary collection devices
  • Nebulizer Equipment and/or Supplies - Nebulizers, Atomizers, Filters
  • Surgical Dressings - Gauze, Elastic bandages, Adhesive tape

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
24D2173502
Facility Type
Pharmacy
Certificate Effective Date
October 15, 2025
Certificate Expiration Date
October 14, 2027
Laboratory Director
TRACY L. JONES
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Coborn's Clinic Pharmacy # 2017 to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1194101766, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
9
Doubled → 18 → 1 + 8
Pos 4
4
Unchanged
Pos 5
1
Doubled → 2
Pos 6
0
Unchanged
Pos 7
1
Doubled → 2
Pos 8
7
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 9 → 18 → 9 1 → 2 1 → 2 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 8 + 4 + 2 + 0 + 2 + 7 + 1 + 2 + 24 = 54

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1194101766.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Pharmacist
710 FRANKIE LN
MORA, MN 55051
Pharmacy (Community/Retail Pharmacy)
710 FRANKIE LN
MORA, MN 55051
Pharmacist
710 FRANKIE LN
MORA, MN 55051
Pharmacist
710 FRANKIE LN
MORA, MN 55051

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1194101766, enumerated as an "organization" on August 06, 2015.

The provider is located at 710 FRANKIE LN MORA, MN 55051 and the phone number is (320) 679-2363.

Health Maintenance Organization with taxonomy code 302R00000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.