Organization
PAMIDA STORES OPERATING CO LLC
Active
Other names
Pamida Pharmacy 329
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN HARLOW (CEO/PRESIDENT)
(402) 596-7206
Entity
Organization
Contact information
Practice address
200 PAUL BUNYAN DR S, BEMIDJI, MN 56601-3241
(218) 751-8063
(218) 751-8064
Mailing address
200 PAUL BUNYAN DR S, BEMIDJI, MN 56601-3241
(218) 751-8063
(218) 751-8064
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
262777-9
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2420191
NCPDP
—
05
—
468760400
—
MN
05
—
987497000
—
MN
Enumeration date
05/19/2006
Last updated
11/23/2009
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