Organization
SUMMERS PHARMACY NO 11 INC
Active
Other names
Summers Pharmacy - Boonville
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN SUMMERS (OWNER/PRESIDENT)
(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
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
002291
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2048680
PK
—
05
—
600284400
—
MO
Enumeration date
11/22/2006
Last updated
01/21/2021
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