Organization
PAMIDA STORES OPERATING CO LLC
Active
Other names
Pamdia Pharmacy 851
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL ROTHAMEL (SR VICE PRESIDENT)
(402) 596-7499
Entity
Organization
Contact information
Practice address
101 S POLK ST, ALBANY, MO 64402-1617
(507) 831-0263
(507) 831-0263
Mailing address
101 S POLK ST, ALBANY, MO 64402-1617
(507) 831-0263
(507) 831-0263
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
2004017362
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2635540
NCPDP
—
Enumeration date
09/07/2007
Last updated
09/07/2007
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