Summers Pharmacy of Slater, LLC

Organization Active NPI Community/Retail Pharmacy · Slater, MO

NPI 1053953109 · NPPES record last updated Mar 1, 2022

Key facts

NPI
1053953109
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
SUMMERS PHARMACY OF SLATER, LLC
Practice address
102 E Maple St
Slater, MO 65349-1539
Phone
(660) 529-9908
Fax
(660) 529-9918
NPI assigned
Oct 10, 2019
Organization subpart
Yes
Parent organization (as reported)
SUMMERS PHARMACY ENTERPRISES, CORP

Authorized official

Name
Ryan K Summers, PHARM D
Title
President
Phone
(660) 885-3034

National Provider Directory

Locations

605 Pawnee St
Clinton, MO 64735
Phone (660) 383-1910

102 E Maple St
Slater, MO 65349
Phone (660) 529-9908

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Yes
Compounding Pharmacy 3336C0004X
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

102 E Maple St
Slater, MO 65349-1539

Mailing address

605 Pawnee St
Clinton, MO 64735-2757
Phone (660) 383-1910

Other identifiers

IdentifierTypeStateIssuer
600078489MedicaidMO

Other providers in Slater, MO

All providers in Slater, MO · Community/Retail Pharmacy in Missouri

Sources for this page

Verify at the official NPI Registry.