Active NPI
Alexander Tucker Peterson, PHARMD
- Community/Retail Pharmacy
- Tooele, UT
National Provider Identifier
1649971516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 10898394-1701
- Practice address
- 99 W 1280 N
Tooele, UT 84074-9093 - Phone
- (435) 882-0150
- Fax
- (435) 882-1023
- NPI assigned
- Mar 16, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 10898394-1701 | UT | Primary |
Addresses
Primary practice location
99 W 1280 N
Tooele, UT 84074-9093
Mailing address
99 W 1280 N
Tooele, UT 84074-9093
Phone (435) 882-0150
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10898394-1701 | UT | MD | Community/Retail Pharmacy |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678924800000",
"number": "1649971516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 W 1280 N",
"city": "TOOELE",
"state": "UT",
"postal_code": "840749093",
"telephone_number": "435-882-0150",
"fax_number": "435-882-1023"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 W 1280 N",
"city": "TOOELE",
"state": "UT",
"postal_code": "840749093",
"telephone_number": "435-882-0150",
"fax_number": "435-882-1023"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSON",
"first_name": "ALEXANDER",
"middle_name": "TUCKER",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-16",
"last_updated": "2023-03-16",
"certification_date": "2023-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "UT",
"license": "10898394-1701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tooele, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.