Provider Demographics
NPI:1477668408
Name:AUBURN PHARMACY INC
Entity Type:Organization
Organization Name:AUBURN PHARMACY INC
Other - Org Name:AUBURN PHARMACY #168
Other - Org Type:Doing Business As
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 1:716 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:66839-1286
Mailing Address - Country:US
Mailing Address - Phone:620-364-3388
Mailing Address - Fax:620-364-3381
Practice Address - Street 1:716 N 4TH ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:KS
Practice Address - Zip Code:66839-1286
Practice Address - Country:US
Practice Address - Phone:620-364-3388
Practice Address - Fax:620-364-3381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200484650CMedicaid
KS2-113535OtherKS BOP LICENSE
KS2-113535OtherKS BOP LICENSE