# PETERSON MARKET LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Peterson's Fresh Market
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780917930
- **Authorized official:** MONTE PETERSON (CHAIRMAN/OWNER)
- **Authorized official phone:** (801) 254-0761

## Contact information

- **Practice address:** 1784 W 12600 S, RIVERTON, UT 84065-7025
- **Practice address phone:** (801) 254-0809
- **Practice address fax:** (801) 254-5982
- **Mailing address:** 1784 W 12600 S, RIVERTON, UT 84065-7025
- **Mailing address phone:** (801) 254-0809
- **Mailing address fax:** (801) 254-5892

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 86317321703 | UT | Yes |

## Other

- **Enumeration date:** 09/04/2009
- **Last updated:** 11/14/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2140532 | PK | — |