Organization
SEELY ENTERPRISES
Active
Other names
TERRELS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER PETERSON DOC OF PHARMACY (PHCY MANG)
(435) 462-6300
Entity
Organization
Contact information
Practice address
1050 S STATE ST, MOUNT PLEASANT, UT 84647-2206
(435) 462-6300
(435) 462-6301
Mailing address
1050 S STATE ST, 1050 S STATE STREET, MOUNT PLEASANT, UT 84647-2206
(435) 462-6300
(435) 462-6301
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
6749847-1703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2100974
PK
—
Enumeration date
02/28/2008
Last updated
02/20/2017
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