Organization Active NPI

Peterson Family Drug LLC

Doing business as Huntridge Drug

  • Community/Retail Pharmacy
  • Las Vegas, NV
National Provider Identifier
1285851386
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH02165 Issued in NV
Legal business name
PETERSON FAMILY DRUG LLC
Doing business as
Huntridge Drug
Practice address
1144 E Charleston Blvd
Las Vegas, NV 89104-1558
Phone
(702) 382-7373
Fax
(702) 382-5927
NPI assigned
Apr 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shari Bock
Title
Owner
Phone
(702) 382-7373

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PH02165 NV Primary

Addresses

Primary practice location

1144 E Charleston Blvd
Las Vegas, NV 89104-1558

Mailing address

1144 E Charleston Blvd
Las Vegas, NV 89104-1558
Phone (702) 382-7373

Other identifiers 2

IdentifierTypeStateIssuer
2052232OtherPK
1285851386MedicaidNV

Other names 1

  • Huntridge Drug Doing business as

National Provider Directory

National Provider Directory

Locations

1144 E Charleston Blvd
Las Vegas, NV 89104
Phone (702) 382-7373

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1285851386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 E CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041558",
            "telephone_number": "702-382-7373",
            "fax_number": "702-382-5927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1144 E CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891041558",
            "telephone_number": "702-382-7373",
            "fax_number": "702-382-5927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON FAMILY DRUG LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "BOCK",
        "authorized_official_first_name": "SHARI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-382-7373"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NV",
            "license": "PH02165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2052232",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285851386",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Huntridge Drug",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.