Organization
PAMIDA STORES OPERATING CO LLC
Active
Other names
Pamida Pharmacy 853
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL E ROTHAMEL (SR VICE PRESIDENT)
(402) 596-7499
Entity
Organization
Contact information
Practice address
1021 W BUCHANAN ST, CALIFORNIA, MO 65018-1238
(573) 796-8002
(573) 796-8004
Mailing address
1021 W BUCHANAN ST, CALIFORNIA, MO 65018-1238
(573) 796-8002
(573) 796-8004
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2006008264
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2635449
NCPDP
—
05
—
602586109
—
MO
Enumeration date
09/06/2007
Last updated
05/07/2008
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