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AUBURN PHARMACY
SCH170120-00 LABETTE COUNTY MEDICAL CENTER D/B/A LABETTE HEALTH
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Covered Entity Details
Entity Name
LABETTE COUNTY MEDICAL CENTER D/B/A LABETTE HEALTH
Subdivision Name
Type
Sole Community Hospital
340B ID
SCH170120-00
Entity Address
1902 S US HWY 59
PARSONS, KS 67357
Medicare Provider Number
170120
Participating Start Date
1/1/2011
Last Recertification Date
8/13/2024
Pharmacy Details
Pharmacy Name
AUBURN PHARMACY
Pharmacy Address
2020 MAIN
PARSONS, KS 67357
Pharmacy Comments
Contract Details
Approval Date
1/15/2014
Contract Begin Date
4/1/2014
Carve-In Effective Date
Contract Comments
Contract Termination Date
Termination Reason
2/18/2021
Pharmacy closed
Contacts
Covered Entity Signing Official
TOM MACARONAS, CFO
(620) 820-5251
Contract Pharmacy Representative
AuBurn Pharmacies
Michael W. Burns, President/CEO
(785) 448-3600
Signed By Date
1/15/2014
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