Organization
NIEMANN FOODS INC
Active
Other names
County Market Pharmacy 397
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER NIEMANN (EVP / CFO)
(217) 221-5615
Entity
Organization
Contact information
Practice address
1106 S BUSINESS HIGHWAY 61, BOWLING GREEN, MO 63334-5233
(573) 324-3383
(573) 324-6388
Mailing address
PO BOX C847, QUINCY, IL 62306-0847
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
2014014138
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2145211
PK
—
05
—
600121420
—
MO
Enumeration date
11/15/2005
Last updated
09/27/2021
Update your record
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