Organization
TARGET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ATHENA PETERSON PHARMD (PHARMACIST)
(203) 217-1562
Entity
Organization
Contact information
Practice address
474 CHAMBERLAIN HWY, MERIDEN, CT 06451-1818
(203) 634-6060
Mailing address
474 CHAMBERLAIN HWY, MERIDEN, CT 06451-1818
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
0013072
CT
Other
Enumeration date
09/22/2015
Last updated
09/22/2015
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