Peterson Foodtown Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

6120204-1703 Issued in UT

Legal business name

PETERSON FOODTOWN INC

Doing business as

PETERSONS PHARMACY

Practice address

1777 W 12600 S
Riverton, UT 84065-7043

Phone

(801) 254-0809

Fax

(801) 254-5982

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

Monte Peterson, RPH

Title

Pres

Phone

(801) 254-0761

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• PETERSONS PHARMACY Doing business as

Locations

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363910400000",
    "number": "1598776148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 W 12600 S",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657043",
            "telephone_number": "801-254-0809",
            "fax_number": "801-254-5982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 W 12600 S",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657043",
            "telephone_number": "801-254-0809",
            "fax_number": "801-254-5982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETERSON FOODTOWN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2013-03-22",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "MONTE",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "801-254-0761",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "UT",
            "license": "6120204-1703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "4610514",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PETERSONS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer J. Peacock, DNP, APRN, NNP-BC
• Haley H Pedersen, FNP-C
• Pediatric Inpatient Services Riverton
• Kenna Renee Peters, PT
• Rylee Petersen
• Peterson Market LLC
• Jeffrey Steven Peterson, MD
• John Michael Peterson, DDS
• Jordan Peterson
• Kirstin Peterson, LCSW

• Community/Retail Pharmacy in Riverton, UT
• Providers in Riverton, UT by specialty
• Community/Retail Pharmacy in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.