Organization
SUMMERS PHARMACY OF NEVADA LLC
Active
Parent organization
SUMMERS PHARMACY ENTERPRISES, CORP
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUMMERS PHARMACY ENTERPRISES, CORP
Authorized official
RYAN SUMMERS (PRESIDENT)
(660) 885-3034
Entity
Organization
Contact information
Practice address
900 S ADAMS ST, NEVADA, MO 64772-3210
(417) 667-6044
(417) 667-0544
Mailing address
605 PAWNEE ST, CLINTON, MO 64735-2757
(417) 667-6044
(417) 667-0544
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
2016010547
MO
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159366
PK
—
05
—
600447304
—
MO
Enumeration date
11/20/2006
Last updated
07/10/2019
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