Organization
PETERSON DRUG COMPANY OF NEWFANE NY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLENN C. PETERSON (PRESIDENT)
(716) 778-7422
Entity
Organization
Contact information
Practice address
2740 MAIN ST, NEWFANE, NY 14108-1206
(716) 778-7422
(716) 778-5289
Mailing address
2740 MAIN ST, NEWFANE, NY 14108-1206
(716) 778-7422
(716) 778-5289
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
009819
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00608177
—
NY
01
—
3341384
NCPDP NUMBER
NY
Enumeration date
02/14/2007
Last updated
03/07/2023
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