Organization
SUMMERS PHARMACY NO 11 INC
Active
Other names
Summers Pharmacy - Long Term Care
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN KENT SUMMERS (OWNER)
(660) 885-3034
Entity
Organization
Contact information
Practice address
800 MAIN ST, BOONVILLE, MO 65233-1658
(660) 882-5208
(660) 882-8125
Mailing address
605 PAWNEE ST, CLINTON, MO 64735-2757
(660) 383-1910
(660) 885-5888
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
10/26/2020
Last updated
10/26/2020
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