Petersonrx, LLC
Pharmacy, Community/Retail Pharmacy in South Amboy, NJ. Organization (NPI-2).
NPI number1265854343
StatusActive
Last updated in NPPESJan 9, 2014
Details
- NPI
- 1265854343
- Entity type
- Organization (NPI-2)
- Legal business name
- Petersonrx, LLC
- Organization subpart
- No
- Enumeration date
- Jan 9, 2014
- Last updated
- Jan 9, 2014
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 28RS00559800 | NJ | Yes |
Other names
- Peterson Pharmacy (Doing Business As)
Practice location
125 N BroadwaySouth Amboy, NJ 08879-1639
Phone 732-721-0137 · Fax 732-721-0134
Mailing address
125 N BroadwaySouth Amboy, NJ 08879-1639
Phone 732-721-0137 · Fax 732-721-0134
Authorized official
Dow Jones
Owner
7327210137
Is something wrong?
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