# PETERSON PHARMACY INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** PETERSON PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144246000
- **Authorized official:** SELMA DZELIL (VP RDO)
- **Authorized official phone:** (815) 715-8502

## Contact information

- **Practice address:** 727 WATER AVE, HILLSBORO, WI 54634-6229
- **Practice address phone:** (608) 489-3141
- **Practice address fax:** (608) 489-2821
- **Mailing address:** 727 WATER AVE, HILLSBORO, WI 54634-6229
- **Mailing address phone:** (608) 489-3141
- **Mailing address fax:** (608) 489-2821

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 7133-42 | WI | Yes |

## Other

- **Enumeration date:** 07/14/2006
- **Last updated:** 07/10/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2115157 | PK | — |
| 05 | — | 33175900 | — | WI |