Summers Pharmacy of Appleton City, Inc
Organization Active NPI Community/Retail Pharmacy · Appleton City, MO
NPI 1477582625 · NPPES record last updated May 14, 2021
Key facts
- NPI
- 1477582625
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 5541 (MO)
- Legal business name
- SUMMERS PHARMACY OF APPLETON CITY, INC
- Practice address
- 121 W 4TH St
Appleton City, MO 64724 - Phone
- (660) 476-2142
- Fax
- (660) 476-5563
- NPI assigned
- Jul 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Julia Summers
- Title
- President
- Phone
- (660) 383-1910
Practitioners 1
-
Darrell D Anstine, RPH
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200317002709 | MO | DME Supplier - Pharmacy |
1254769615 | Practice locations: Appleton City, MO |
| O20201216001873 | MO | Part B Supplier - Mass Immunization (Roster Biller Only) | 1254769615 | Practice locations: Appleton City, MO |
National Provider Directory
Locations
121 W 4th St
Appleton City, MO 64724
Phone (660) 476-2142
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 5541 | MO | Yes |
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
121 W 4TH St
Appleton City, MO 64724
Mailing address
605 Pawnee Street
Clinton, MO 64735
Phone (660) 383-1910
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20200012041 | Other | MO | BOP |
| 602280703 | Medicaid | MO |
Other providers in Appleton City, MO
- Donald Clifford Payton Jr.
- Delana Ann Poore
- Aubrey L Siegismund
- David Alan Strauch
- Kelly Jo Strope
- Summers Pharmacy of Appleton City, Inc
- The Journey to Peace of Mind Counseling, LLC
- West Central Missouri Community Action Agency
- West Central Missouri Community Action Agency
- West Central Missouri Community Action Agency
All providers in Appleton City, MO · Community/Retail Pharmacy in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.