Organization
NIEMANN FOODS INC
Active
Other names
County Market Pharmacy 392
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER NIEMANN (EVP / CFO)
(217) 221-5615
Entity
Organization
Contact information
Practice address
1555 W US HIGHWAY 54, VANDALIA, MO 63382-1158
(573) 594-2136
(573) 594-2744
Mailing address
PO BOX C847, QUINCY, IL 62306-0847
(217) 221-5641
(217) 221-5929
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
2013038172
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2141913
PK
—
05
—
600280309
—
MO
Enumeration date
01/31/2007
Last updated
09/27/2021
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