Organization
PETERSON PHARMACY INCORPORATED
Active
Other names
Peterson Pharmacy Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MYRON D SYLVESTER RPH (PHARMACIST)
(320) 275-3052
Entity
Organization
Contact information
Practice address
440 4TH ST, DASSEL, MN 55325-4543
(320) 275-3052
(320) 275-2591
Mailing address
440 4TH ST, PO BOX 280, DASSEL, MN 55325-4543
(320) 275-3052
(320) 275-2591
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
260192
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2404399
NCPDP
MN
01
—
260192
STATE LICENSE NUMBER
MN
05
—
840858100
—
MN
Enumeration date
02/20/2007
Last updated
03/07/2023
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