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Organization

PAMIDA STORES OPERATING CO LLC

Active
Other names
Pamida Pharmacy 349
Organization subpart
No

Provider details

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

Contact information

Practice address
5350 STATION DR, CALUMET, MI 49913-1853
(906) 337-3597
(906) 337-3695
Mailing address
5350 STATION DR, CALUMET, MI 49913-1853
(906) 337-3597
(906) 337-3695

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
3336C0003X
Community/Retail Pharmacy
Primary
5301008374
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2354962
NCPDP NUMBER
05
2354962
MI
05
3192487
MI
05
4819167
MI
05
4913857
MI
Enumeration date
05/17/2006
Last updated
11/23/2009
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