Provider Demographics
NPI:1366918641
Name:AUBURN PHARMACY, INC.
Entity type:Organization
Organization Name:AUBURN PHARMACY, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:785-448-3600
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:LINDSBORG
Mailing Address - State:KS
Mailing Address - Zip Code:67456-0309
Mailing Address - Country:US
Mailing Address - Phone:785-227-3374
Mailing Address - Fax:785-227-2509
Practice Address - Street 1:216 N HARRISON ST
Practice Address - Street 2:
Practice Address - City:LINDSBORG
Practice Address - State:KS
Practice Address - Zip Code:67456-2216
Practice Address - Country:US
Practice Address - Phone:785-227-3374
Practice Address - Fax:785-227-2509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100439770RMedicaid
KS100439770QMedicaid