# PETERSON PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437802634
- **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

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 01/28/2022
- **Last updated:** 09/25/2023