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NPI Code Detail

MEDICARE: DR. ADAM CHARLES NIEMEYER PHARMD

MEDICARE: DR. ADAM CHARLES NIEMEYER PHARMD
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
1183500000XPharmacist15419-40WI
2183500000XPharmacist051.292527IL

General Provider Information

NPI Number : 1912293366
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ADAM CHARLES NIEMEYER PHARMD
Provider Business Mailing Address
First Line : 800 BROADVIEW VILLAGE SQ
Second Line : T2081
City : BROADVIEW
State : IL
Zip : 60155-4887
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 800 BROADVIEW VILLAGE SQ
Second Line : T2081
City : BROADVIEW
State : IL
Zip : 60155-4887
Country : US
Telephone Number : 708-731-5556
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2011
Last Update Date : 06/23/2011

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