SUMMERS PHARMACY NO 11 INC
NPI 1619576139
Pharmacy - Long Term Care Pharmacy in Boonville, MO

Active since October 26, 2020CLIA 26D2198428 · Waiver
800 MAIN ST, BOONVILLE, MO 65233(660) 882-5208(660) 882-8125 Get Directions Write a Review

NPPES record last updated: October 26, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Summers Pharmacy No 11 Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUMMERS PHARMACY NO 11 INC (NPI 1619576139), doing business as Summers Pharmacy - Long Term Care, is a healthcare organization registered as a long term care pharmacy in Boonville, Missouri and active in the NPI registry since October 2020. The organization holds a CLIA Waiver certificate valid through November 1, 2026 and lists Ryan Kent Summers, Owner, as its authorized official.

NPPES Registry Identity

NPI1619576139
Entity TypeOrganization
Primary Taxonomy3336L0003X
Legal Business NameSUMMERS PHARMACY NO 11 INC
Location Address800 MAIN STBoonville, MO 65233-1658
Mailing Address605 Pawnee StClinton, MO 64735-2757 · (660) 383-1910 · Fax (660) 885-5888
Fax(660) 882-8125
Organization SubpartNo
Authorized OfficialRyan Kent SummersOwner · (660) 885-3034
Enumeration DateOctober 26, 2020
NPPES CertifiedOctober 22, 2020
NPI 1619576139 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacy · Long Term Care PharmacySuppliers
Taxonomy Code3336L0003X
Definition

A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

800 MAIN ST, Boonville, MO 65233

Other Names 1

Doing Business AsSummers Pharmacy - Long Term Care

Other Identifiers 1

MedicaidPENDINGMO

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2198428

Summers Pharmacy Of Boonville · Boonville, MO
Active · expires Nov 1, 2026
CLIA Number26D2198428
Laboratory TypePharmacy
Certificate Effective DateNovember 2, 2024
Certificate Expiration DateNovember 1, 2026
Laboratory DirectorRyan Summers
Laboratory Phone(660) 882-5208
Laboratory LocationSummers Pharmacy Of Boonville800 Main St, Boonville, MO 65233
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
20411471
Accepts Medicare Assignment
YES
Specialities List
Pharmacy.
Competitive Bidding
NO

Supplies List

  • Epoetin - Epoetin is a man-made version of human erythropoietin (EPO)
  • Immunosuppressive Drugs - Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
  • Nebulizer Drugs - Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
  • Oral Anticancer Drugs - FDA anticancer drugs
  • Oral Antiemetic Drugs - FDA antiemetic drugs

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacy (Community/Retail Pharmacy)
800 MAIN ST
BOONVILLE, MO 65233
Pharmacist
800 MAIN ST
BOONVILLE, MO 65233
Pharmacy (Community/Retail Pharmacy)
800 MAIN ST
BOONVILLE, MO 65233
Pharmacist
800 MAIN ST
BOONVILLE, MO 65233
Pharmacist
800 MAIN ST
BOONVILLE, MO 65233

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1619576139, enumerated as an "organization" on October 26, 2020.

The provider is located at 800 MAIN ST BOONVILLE, MO 65233 and the phone number is (660) 882-5208.

Pharmacy with taxonomy code 3336L0003X and a focus in Long Term Care Pharmacy.

The provider might be accepting Accepts: Antidote Health Plan of Arizona, Inc., Antidote. Please consult your insurance carrier or call the provider to verify.