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Organization
NIEMANN FOODS INC
Active
Organization
NIEMANN FOODS INC
Active
Other names
County Market Pharmacy 409
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER NIEMANN (EVP/CFO)
(217) 221-5615
Entity
Organization
Contact information
Practice address
1805 ELM ST, CANTON, MO 63435-1685
(573) 288-5151
(573) 288-0352
Mailing address
PO BOX C847, QUINCY, IL 62306-0847
(217) 221-5641
(217) 221-5915
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
2011023099
MO
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2129007
PK
—
05
—
606556306
—
MO
Enumeration date
02/25/2011
Last updated
09/27/2021
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