{
  "npi": "1982968640",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "PharmD",
    "authorized_official_first_name": "REBECCA",
    "authorized_official_last_name": "PICKLER",
    "authorized_official_telephone_number": "3202515505",
    "authorized_official_title_or_position": "Director Of Pharmacy",
    "certification_date": "2025-12-08",
    "enumeration_date": "2012-06-27",
    "last_updated": "2025-12-08",
    "organization_name": "COBORNS INC",
    "organizational_subpart": "YES",
    "parent_organization_legal_business_name": "COBORNS INC",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "PO BOX 6146",
      "address_2": "PO BOX 6146",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "SAINT CLOUD",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "320-203-1095",
      "postal_code": "563026146",
      "state": "MN",
      "telephone_number": "320-251-5505"
    },
    {
      "address_1": "1106 8TH ST SW",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "PIPESTONE",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "855-297-5312",
      "postal_code": "561641078",
      "state": "MN",
      "telephone_number": "507-825-0091"
    }
  ],
  "taxonomies": [
    {
      "code": "332BP3500X",
      "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "3336L0003X",
      "desc": "Pharmacy, Long Term Care Pharmacy",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "332BC3200X",
      "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "333600000X",
      "desc": "Pharmacy",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "3336C0003X",
      "desc": "Pharmacy, Community/Retail Pharmacy",
      "license": "263895",
      "primary": true,
      "state": "MN",
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": {
    "total_beneficiaries": "162",
    "total_services": "537",
    "total_medicare_allowed_amt": "40207.81",
    "top_hcpcs_services": [
      {
        "code": "90480",
        "description": "Admn sarscov2 vacc 1 dose",
        "services": "114",
        "beneficiaries": "112"
      },
      {
        "code": "90653",
        "description": "Influenza vaccine, inactivated",
        "services": "124",
        "beneficiaries": "124"
      },
      {
        "code": "90656",
        "description": "Influenza vaccine, trivalent, split virus, preservative-free, 0.5 ml dosage",
        "services": "16",
        "beneficiaries": "16"
      },
      {
        "code": "91322",
        "description": "Sarscov2 vac 50 mcg/0.5ml im",
        "services": "115",
        "beneficiaries": "112"
      },
      {
        "code": "G0008",
        "description": "Administration of influenza virus vaccine",
        "services": "142",
        "beneficiaries": "142"
      },
      {
        "code": "G0009",
        "description": "Administration of pneumococcal vaccine",
        "services": "11",
        "beneficiaries": "11"
      }
    ]
  },
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Suppliers — Pharmacy, Community — Retail Pharmacy",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "58",
        "medicare_type": "Medical Supply Company with Pharmacist"
      },
      {
        "medicare_code": "A5",
        "medicare_type": "Pharmacy"
      }
    ]
  }
}