MEDICARE: AUBURN PHARMACY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336L0003X	Long Term Care Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356817647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUBURN PHARMACY, INC.

Provider Business Mailing Address
First Line	:	890 LAKIN ST
Second Line	:
City	:	OSAGE CITY
State	:	KS
Zip	:	66523-1152
Country	:	US
Telephone Number	:	785-528-4415
Fax Number	:	785-528-4930

Provider Business Practice Location Address
First Line	:	890 LAKIN ST
Second Line	:
City	:	OSAGE CITY
State	:	KS
Zip	:	66523-1152
Country	:	US
Telephone Number	:	785-528-4415
Fax Number	:	785-528-4930

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MICHAEL W BURNS
Credential	:	RPH
Telephone Number	:	785-448-3600

Provider Enumeration Date	:	10/15/2018
Last Update Date	:	06/12/2020

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