NPIMap

Organization Active NPI

Auburn Pharmacy Inc

Doing business as AuBurn Pharmacy #130

  • Community/Retail Pharmacy
  • Paola, KS
National Provider Identifier
1124111034
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
2-09044 Issued in KS
Legal business name
AUBURN PHARMACY INC
Doing business as
AuBurn Pharmacy #130
Practice address
311 N Hospital Dr
Paola, KS 66071-1303
Phone
(913) 294-3516
Fax
(913) 294-8411
NPI assigned
Oct 2, 2006
Last updated
Nov 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael W Burns, RPH
Title
Owner/Ceo
Phone
(785) 448-3600

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 2012025308 MO
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 2-09044 KS Primary
Compounding Pharmacy 3336C0004X NU

Addresses

Primary practice location

311 N Hospital Dr
Paola, KS 66071-1303

Mailing address

259 W Park Rd
Garnett, KS 66032-1080
Phone (913) 294-3516

Other identifiers 2

IdentifierTypeStateIssuer
201174430OMedicaidKS
201174430RMedicaidKS

Other names 1

  • AuBurn Pharmacy #130 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050712001108 KS Part B Supplier - Mass Immunization (Roster Biller Only) 1355377276 19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Garnett, KS
O20190122003168 KS DME Supplier - PharmacyDME Supplier - Medical Supply Company With Registered Pharmacist 1355377276 Practice locations: Paola, KS

Other NPIs on the same Medicare enrollment 19

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 19

National Provider Directory

National Provider Directory
Tax ID family
Auburn Pharmacy Inc53 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Locations

19 S Pearl St
Paola, KS 66071
Phone (913) 294-3516

311 N Hospital Dr
Paola, KS 66071
Phone (913) 294-3516

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Villa MariaMulvane, KS, CCN 175456 Skilled nursing facility Adp of the SNF Jul 1, 2025

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636934400000",
    "number": "1124111034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 W PARK RD",
            "city": "GARNETT",
            "state": "KS",
            "postal_code": "660321080",
            "telephone_number": "913-294-3516",
            "fax_number": "913-294-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N HOSPITAL DR",
            "city": "PAOLA",
            "state": "KS",
            "postal_code": "660711303",
            "telephone_number": "913-294-3516",
            "fax_number": "913-294-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUBURN PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "785-448-3600",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MO",
            "license": "2012025308",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "KS",
            "license": "2-09044",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201174430O",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201174430R",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AuBurn Pharmacy #130",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Paola, KS

Sources for this page

Verify at the official NPI Registry.