MEDICARE: DR. KEVIN RICHARD PETERSON PHARMD RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	11834	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	11834	OTHER	NE	PHARMACY LICENSE

General Provider Information

NPI Number	:	1174712434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KEVIN RICHARD PETERSON PHARMD RPH

Provider Business Mailing Address
First Line	:	2324 S 156TH CIR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68130-2511
Country	:	US
Telephone Number	:	402-330-5482
Fax Number	:	402-330-2697

Provider Business Practice Location Address
First Line	:	2324 S 156TH CIR
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68130-2511
Country	:	US
Telephone Number	:	402-330-5482
Fax Number	:	402-330-2697

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2007
Last Update Date	:	01/04/2010

Similar Medicare Providers

1518959295 — DR. BONNIE JEAN LEES MD
Practice Location Address:

8200 DODGE STREET , CHILDREN'S HOSPITAL & MEDICARE CENTER
OMAHA, NE
68114-4113

Practice Phone: 402-955-6140
Practice Fax: 402-955-3398

1255664207 — DONI ANN KEELING
Practice Location Address:

2511 S 43RD ST
OMAHA, NE
68105-3311

Practice Phone: 402-660-4929
Practice Fax:

1710332234 — HANNAH BERAN D.C.
Practice Location Address:

11404 W DODGE RD STE 300
OMAHA, NE
68154-2511

Practice Phone: 402-919-4029
Practice Fax:

1609328475 — WEST MAPLE COUNSELING ASSOCIATES
Practice Location Address:

2511 N 73RD ST
OMAHA, NE
68134-6802

Practice Phone: 402-393-0133
Practice Fax: 402-391-0498

1801331525 — PAIGE STALLINGS
Practice Location Address:

11404 W DODGE RD STE 300
OMAHA, NE
68154-2511

Practice Phone: 402-898-1113
Practice Fax:

1336680396 — MRS. KRISTI BOSE APRN
Practice Location Address:

11404 W DODGE RD STE 300
OMAHA, NE
68154-2511

Practice Phone: 402-898-1113
Practice Fax: 402-819-5588

Directions to “ DR. KEVIN RICHARD PETERSON PHARMD RPH” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.