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Organization

PAMIDA STORES OPERATING CO LLC

Active
Other names
Pamida Pharmacy 13
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JOHN HARLOW (CEO/PRESIDENT)
(402) 596-7206
Entity
Organization

Contact information

Practice address
801 JEFFERSON ST N, WADENA, MN 56482-2334
(218) 631-1546
(218) 631-1548
Mailing address
801 JEFFERSON ST N., WADENA, MN 56482-2334
(218) 631-1546
(218) 631-1548

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
262786-3
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005450100
MN
01
2425040
NCPDP
05
769418100
MN
Enumeration date
05/20/2006
Last updated
11/23/2009
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