Organization
PAMIDA STORES OPERATING CO., LLC
Active
Organization
PAMIDA STORES OPERATING CO., LLC
Active
Parent organization
PAMIDA STORES OPERATING CO., LLC
Other names
Pamida Pharmacy 687
Organization subpart
Yes
Provider details
NPI number
Legal business name
PAMIDA STORES OPERATING CO., LLC
Authorized official
MR. JOHN HARLOW (PRESIDENT/CEO)
(402) 596-7206
Entity
Organization
Contact information
Practice address
118 SOUTH INTEROCEAN AVE, HOLYOKE, CO 80734
(970) 854-3400
Mailing address
118 SOUTH INTEROCEAN AVE, HOLYOKE, CO 80734
(970) 854-3400
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
PDO-620000001
CO
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025658900
—
NE
05
—
44437323
—
CO
Enumeration date
04/09/2008
Last updated
11/23/2009
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