Healthcare Provider Details

I. General information

NPI: 1699616953
Provider Name (Legal Business Name): AUBURN PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 E 10TH ST STE B
HOLDEN MO
64040
US

IV. Provider business mailing address

259 W PARK RD
GARNETT KS
66032
US

V. Phone/Fax

Practice location:
  • Phone: 816-732-5514
  • Fax:
Mailing address:
  • Phone: 785-448-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: JORI MOORE
Title or Position: THIRD PARTY SUPPORT
Credential:
Phone: 785-448-3600