Healthcare Provider Details

I. General information

NPI: 1639276249
Provider Name (Legal Business Name): AUBURN PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2006
Last Update Date: 06/12/2020
Certification Date: 06/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 S OAK
NEVADA MO
64772
US

IV. Provider business mailing address

259 W PARK RD
GARNETT KS
66032-1080
US

V. Phone/Fax

Practice location:
  • Phone: 417-667-7802
  • Fax: 417-667-7803
Mailing address:
  • Phone: 854-483-6007
  • Fax: 785-448-3206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number2944
License Number StateMO
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL W BURNS
Title or Position: OWNER/CEO
Credential: RPH.
Phone: 785-448-3600