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NPI Code Detail

MEDICARE: NIEMANN FOODS INC

MEDICARE: NIEMANN FOODS INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336L0003XLong Term Care Pharmacy
33336C0003XCommunity/Retail Pharmacy054.019852IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12157302OTHERPK

General Provider Information

NPI Number : 1326064361
Entity Type Code : Organization
Provider Name (Legal Business Name) : NIEMANN FOODS INC
Provider Business Mailing Address
First Line : PO BOX C847
Second Line :
City : QUINCY
State : IL
Zip : 62306-0847
Country : US
Telephone Number : 217-221-5641
Fax Number : 217-221-5929
Provider Business Practice Location Address
First Line : 1099 JASON PL
Second Line :
City : CHATHAM
State : IL
Zip : 62629-2018
Country : US
Telephone Number : 217-483-2496
Fax Number : 217-483-5772
Authorized Official
Title or Position : DIRECTOR OF PHARMACY
Name : ARTHUR AWERKAMP
Credential :
Telephone Number : 217-221-5615
Provider Enumeration Date : 07/14/2006
Last Update Date : 09/27/2021

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