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AUBURN PHARMACY, INC.
CAH171385-00 Coffey County Hospital
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Covered Entity Details
Entity Name
Coffey County Hospital
Subdivision Name
Type
Critical Access Hospital
340B ID
CAH171385-00
Entity Address
801 North Fourth
Burlington, KS 66839
Medicare Provider Number
171385
Participating Start Date
4/1/2018
Last Recertification Date
8/27/2024
Pharmacy Details
Pharmacy Name
AUBURN PHARMACY, INC.
Pharmacy Address
AUBURN PHARMACY #168
716 N 4TH ST
BURLINGTON, KS 66839
Pharmacy Comments
Contract Details
Approval Date
1/13/2021
Contract Begin Date
1/13/2021
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Juanita M White, Chief Financial Officer
(620) 364-2121 Ext: 4266
Contract Pharmacy Representative
AUBURN PHARMACY, INC.
Mike Beisner, Pharmacy Operations Director
(620) 364-3388
Signed By Date
1/13/2021
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