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General NPI Number Information
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NPI Number | 1710052709
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Entity Type | Organization
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Legal Business Name | ALPENA SUPERMARKET INC. DBA NEIMAN'S FAMILY MARKET
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 315 EAST MAIN STREET
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City | MAYVILLE
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State | MI
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Zip | 48744
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Country | US
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Telephone | 989-843-6141
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Fax | 989-843-6491
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Provider Business Mailing Address
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Address Line | 1362 RIVER ROAD, BLDG 2 UNIT A&F
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City | SAINT CLAIR
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State | MI
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Zip | 48079
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Country | US
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Telephone | 810-289-3000
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Fax | 989-843-7364
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. BRYAN NEIMAN
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Credential |
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Telephone | 810-289-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301006632
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License Number State | MI
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