Organization
PIONEER PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SOMMER PEDERSEN PHARMD (OWNER AND MANAGER)
(307) 463-8400
Entity
Organization
Contact information
Practice address
832 W MAIN ST, RIVERTON, WY 82501-3342
(307) 463-8400
(307) 463-8401
Mailing address
131 8 MILE RD, RIVERTON, WY 82501-9774
(307) 463-8400
(307) 463-8401
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Enumeration date
06/18/2019
Last updated
06/18/2019
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