Organization
PAMIDA STORES OPERATING CO LLC
Active
Other names
Pamida Pharmacy 337
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN HARLOW (CEO/PRESIDENT)
(402) 596-7206
Entity
Organization
Contact information
Practice address
340 HIGHWAY 65 S, MORA, MN 55051-1619
(320) 679-5950
(320) 679-5956
Mailing address
340 HIGHWAY 65 S, MORA, MN 55051-1619
(320) 679-5950
(320) 679-5956
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
262787-6
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104167000
—
MN
01
—
2421129
NCPDP
—
05
—
477717400
—
MN
Enumeration date
05/20/2006
Last updated
11/23/2009
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