Organization
PAMIDA STORES OPERATING CO LLC
Active
Other names
Pamida Pharmacy 335
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN HARLOW (CEO/PRESIDENT)
(402) 596-7206
Entity
Organization
Contact information
Practice address
705 NORTHLAND DR, PRINCETON, MN 55371-2168
(763) 389-3111
(763) 389-1621
Mailing address
705 NORTHLAND DR, PRINCETON, MN 55371-2168
(763) 389-3111
(763) 389-1621
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
262779-5
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2420836
NCPDP
—
05
—
510864100
—
MN
05
—
848647000
—
MN
Enumeration date
05/18/2006
Last updated
11/23/2009
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