Organization
PAMIDA STORES OPERATING CO LLC
Active
Other names
Pamida Pharmacy 317
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN HARLOW (CEO/PRESIDENT)
(402) 596-7206
Entity
Organization
Contact information
Practice address
520 E HIGHWAY 12 STE 110, LITCHFIELD, MN 55355-2449
(320) 693-7034
(320) 693-7039
Mailing address
520 E HIGHWAY 12 STE 110, LITCHFIELD, MN 55355-2449
(320) 693-7034
(320) 693-7039
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
262795-7
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2419035
NCPDP
—
05
—
768600000
—
MN
05
—
815761800
—
MN
Enumeration date
05/20/2006
Last updated
11/23/2009
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