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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: August 16, 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
Phone(660) 882-5208
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
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Other Names 1

Doing Business AsSummers Pharmacy - Long Term Care

Other Identifiers 1

MedicaidPENDINGMO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc., Avera Health Plans and more.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 Medicare DMEPOS 5

Medicare supplier enrollment and the product categories Summers Pharmacy carries, from the Medicare DMEPOS supplier directory.

Summers Pharmacy

DMEPOS supplier · Boonville, MOOperated by Summers Pharmacy No 11 Inc
✔

Accepts Medicare assignment

Summers Pharmacy agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20411471
Medicare Participant SinceOctober 29, 2020
Supplier Location800 Main StBoonville, MO 65233
Phone(660) 882-5208
Supplier Specialties
Pharmacy

Medicare Product Categories

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
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

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.

MRS. PEGGY MOSER ARMENTROUT PHARMACIST
Pharmacist
800 MAIN ST
BOONVILLE, MO 65233
Cooper County (660) 882-5208
KRISTY L MORRIS
Pharmacist
800 MAIN ST
BOONVILLE, MO 65233
Cooper County (660) 882-5208
MILLERS MEDICAL ARTS INC
Pharmacy (Community/Retail Pharmacy)
800 MAIN ST
BOONVILLE, MO 65233
Cooper County (660) 882-5208
SUMMERS PHARMACY NO 11 INC
Pharmacy (Community/Retail Pharmacy)
800 MAIN ST
BOONVILLE, MO 65233
Cooper County (660) 882-5208
ROBYN SMITH PHARM.D.
Pharmacist
800 MAIN ST
BOONVILLE, MO 65233
Cooper County (636) 345-1653

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Summers Pharmacy No 11 Inc's NPI number?

The NPI number for Summers Pharmacy No 11 Inc is 1619576139. It was assigned to this organization in the NPPES registry on October 26, 2020. The provider is doing business as Summers Pharmacy - Long Term Care.

Where is Summers Pharmacy No 11 Inc located?

Summers Pharmacy No 11 Inc is located at 800 Main St, Boonville, MO 65233. The listed phone number is (660) 882-5208.

What is Summers Pharmacy No 11 Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Long Term Care Pharmacy, with taxonomy code 3336L0003X.

Does Summers Pharmacy No 11 Inc accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Summers Pharmacy accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Summers Pharmacy No 11 Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2198428) is associated with this NPI, valid through November 1, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Summers Pharmacy No 11 Inc accept?

Health plans from Antidote Health Plan of Arizona, Inc., Antidote Health Plan of Ohio, Inc., Avera Health Plans, Baylor Scott and White Health Plan and Blue Cross Blue Shield of North Dakota and 13 other insurers list Summers Pharmacy No 11 Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Summers Pharmacy No 11 Inc was last updated on October 26, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.