Organization
PETERSON PHARMACY INC
Active
Other names
PETERSON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
SELMA DZELIL (VP RDO)
(815) 715-8502
Entity
Organization
Contact information
Practice address
727 WATER AVE, HILLSBORO, WI 54634-6229
(608) 489-3141
(608) 489-2821
Mailing address
727 WATER AVE, HILLSBORO, WI 54634-6229
(608) 489-3141
(608) 489-2821
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
7133-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2115157
PK
—
05
—
33175900
—
WI
Enumeration date
07/14/2006
Last updated
07/10/2023
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