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Search › Idaho › 183500000X

Chax Peterson, PHARM. D

NPI 1407272065 · on the registry since 2014 · sole proprietor

Practice

Address
8093 N Cornerstone Dr
Hayden, ID 83835
Phone
(208) 762-9355
Fax
(208) 762-9198
Organisation at this address
Medicine Man North Pharmacy Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
4

Registry record

Primary taxonomy
183500000X
183500000X
Licence states on file
ID
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2014-03-06

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho