Provider Demographics
NPI:1124216908
Name:DON PETERSON DRUG, INC
Entity Type:Organization
Organization Name:DON PETERSON DRUG, INC
Other - Org Name:SATER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:METZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:417-847-4381
Mailing Address - Street 1:705 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CASSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65625-1421
Mailing Address - Country:US
Mailing Address - Phone:417-847-4381
Mailing Address - Fax:
Practice Address - Street 1:705 MAIN ST
Practice Address - Street 2:
Practice Address - City:CASSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65625-1421
Practice Address - Country:US
Practice Address - Phone:417-847-4381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies