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General NPI Number Information
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NPI Number | 1841558012
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Entity Type | Organization
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Legal Business Name | NIEMANN FOODS INC
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Dates
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Enumeration Date | 04/25/2012
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Last Update Date | 11/25/2020
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Provider Practice Location Address
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Address Line | 518 S MAIN ST
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City | LEWISTOWN
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State | IL
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Zip | 61542-1565
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Country | US
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Telephone | 309-547-3731
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Fax | 309-547-2040
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Provider Business Mailing Address
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Address Line | PO BOX 847
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City | QUINCY
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State | IL
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Zip | 62306-0847
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Country | US
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Telephone | 217-221-5615
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Fax | 217-221-5915
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Authorized Official
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Title or Position | EVP/CFO
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Name | CHRISTOPHER NIEMANN
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Credential |
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Telephone | 217-221-5615
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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 | 054017962
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License Number State | IL
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