Organization
PETES PHARMACY INC
Active
Other names
PETES PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY VONDERFECHT BS (OWNER)
(402) 852-2321
Entity
Organization
Contact information
Practice address
643 G ST, PAWNEE CITY, NE 68420-0072
(402) 852-2322
(402) 852-2928
Mailing address
PO BOX 72, PAWNEE CITY, NE 68420-0072
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
1425
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2053357
PK
—
Enumeration date
10/23/2006
Last updated
01/18/2017
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