Contract Pharmacy Details

AUBURN PHARMACY, INC.
CAH171385-02 Coffey County Hospital

Covered Entity Details

Entity Name

Coffey County Hospital

Subdivision Name

YATES CENTER MEDICAL CLINIC - PRIMARY CARE

Type

Critical Access Hospital

340B ID

CAH171385-02

Entity Address

1004 E. MADISON
YATES CENTER, KS 66783

Medicare Provider Number

171385

Outpatient Facility Provider Number

178559

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

340B Drug Pricing Program Database