Active NPI
Summers Pharmacy No 9, LLC Dba Summers Pharmacy of Cole Camp
- Community/Retail Pharmacy
- Cole Camp, MO
National Provider Identifier
1619982246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 006476
- Legal business name
- SUMMERS PHARMACY NO 9, LLC DBA SUMMERS PHARMACY OF COLE CAMP
- Practice address
- 512 W Main St
Cole Camp, MO 65325-1018 - Phone
- (660) 668-4646
- Fax
- (660) 668-4633
- NPI assigned
- Jul 30, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ryan Summers
- Title
- Owner
- Phone
- (660) 383-1910
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 006476 | MO | Primary |
Addresses
Primary practice location
512 W Main St
Cole Camp, MO 65325-1018
Mailing address
605 Pawnee St
Clinton, MO 64735-2757
Phone (660) 383-1910
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2632075 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| 603807603 | Medicaid | MO |
Other names 2
- COLE CAMP PHARMACY
- Cole Camp Pharmacy Inc.
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Cole Camp, MO
- NPI 1932251949
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154217600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1783036800000",
"number": "1619982246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 PAWNEE ST",
"city": "CLINTON",
"state": "MO",
"postal_code": "647352757",
"telephone_number": "660-383-1910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "512 W MAIN ST",
"city": "COLE CAMP",
"state": "MO",
"postal_code": "653251018",
"telephone_number": "660-668-4646",
"fax_number": "660-668-4633"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUMMERS PHARMACY NO 9, LLC DBA SUMMERS PHARMACY OF COLE CAMP",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-30",
"last_updated": "2026-07-03",
"certification_date": "2026-07-03",
"status": "A",
"authorized_official_last_name": "SUMMERS",
"authorized_official_first_name": "RYAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "660-383-1910"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MO",
"license": "006476",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
"identifier": "2632075",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "603807603",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "COLE CAMP PHARMACY",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Cole Camp Pharmacy Inc.",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Cole Camp, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.