Auburn Pharmacy Inc
Organization Active NPI Pharmacy · Lamar, MO
NPI 1457458069 · NPPES record last updated Jun 4, 2020
Key facts
- NPI
- 1457458069
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 2017039555 (MO)
- Legal business name
- AUBURN PHARMACY INC
- Practice address
- 54B SE 1St LN
Lamar, MO 64759-9226 - Phone
- (417) 682-5838
- Fax
- (417) 682-5811
- NPI assigned
- Sep 19, 2006
- Organization subpart
- No
Authorized official
- Name
- Michael W Burns, RPH
- Title
- Owner/Ceo
- Phone
- (785) 448-3600
Other NPIs on the same Medicare enrollment 10
Corporate family (same tax ID) 18
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D2205825 | Auburn Pharmacy #255 | Certificate of waiver | Dec 15, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Villa Maria |
Skilled nursing facility | Adp of the SNF | Jul 1, 2025 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180217000104 | MO | DME Supplier - Pharmacy |
1355377276 | Practice locations: Lamar, MO |
| O20180219002289 | MO | Part B Supplier - Mass Immunization (Roster Biller Only) | 1355377276 |
10 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Independence, MO; Smithville, MO; Rich Hill, MO; Parkville, MO; Nevada, MO; Mount Vernon, MO; Lamar, MO; Holden, MO… |
National Provider Directory
- Tax ID family
- Auburn Pharmacy Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 2017039555 | MO | Yes |
| Community/Retail Pharmacy | 3336C0003X | |||
| Compounding Pharmacy | 3336C0004X |
Addresses
Primary practice location
54B SE 1St LN
Lamar, MO 64759-9226
Mailing address
259 W Park Rd
Garnett, KS 66032-1080
Phone (785) 448-3600
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2170615 | Other | PK | |
| 601400302 | Medicaid | MO |
Other names
- Auburn Pharmacy #255
Other providers in Lamar, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.