Organization
PETERSON MARKET LLC
Active
Other names
Peterson's Fresh Market
Organization subpart
No
Provider details
NPI number
Authorized official
MONTE PETERSON (CHAIRMAN/OWNER)
(801) 254-0761
Entity
Organization
Contact information
Practice address
1784 W 12600 S, RIVERTON, UT 84065-7025
(801) 254-0809
(801) 254-5982
Mailing address
1784 W 12600 S, RIVERTON, UT 84065-7025
(801) 254-0809
(801) 254-5892
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
86317321703
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140532
PK
—
Enumeration date
09/04/2009
Last updated
11/14/2016
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