Peterson's Supermarket, INC
NPI #1194495051 in Gothenburg, Nebraska
Provider Information
- NPI Number
- 1194495051
- Entity Type
- Organization
- Organization Name
- Peterson's Supermarket, INC
- Primary Specialty
- Pharmacy
- Enumeration Date
- Sep 14, 2021
- Last Updated
- Sep 15, 2021
Practice Location
- Address
- 718 4TH ST
- City
- Gothenburg
- State
- Nebraska
- ZIP Code
- 69138-2347
- Phone
- (308) 537-2048
Authorized Official
- Name
- MICHAEL PETERSON
- Title
- MANAGER OF SUPERMARKET
- Phone
- (308) 537-2048
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
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