Peterson Pharmacy

LBN: Diversified Professional Company
Peterson Pharmacy is an health care organization with primary practice located at 4650 Harrison Blvd , Ogden UT 84403-4303. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Diversified Professional Company can be contacted via phone (801) 479-4030, or through Bailey, Gary Lynn via phone (801) 479-4030.

Contact Information

Primary practice address
4650 Harrison Blvd Ogden UT 84403-4303
Phone: (801) 479-4030
Fax: (801) 475-7051
Website:
Map and Directions
Authorized official contact:
Name: Bailey, Gary Lynn RPH
Phone: (801) 479-4030

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 132801-1703 Utah

Profile Details

NPI number 1396827077
LBN Legal business name Diversified Professional Company
DBA Doing business as Peterson Pharmacy
Authorized official Bailey, Gary Lynn RPH
Entity Organization
Organization subpart 1 No
Enumeration date Oct 20th, 2006
Last updated Feb 19th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396827077 NPPES
Utah MEDICAID 870218488006

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