Organization
NIEMANN FOODS INC
Active
Other names
County Market Pharmacy 212
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER NIEMANN (EVP / CFO)
(217) 221-5615
Entity
Organization
Contact information
Practice address
520 W CLINTON ST, RUSHVILLE, IL 62681-1246
(217) 322-3383
(217) 322-6033
Mailing address
PO BOX C847, QUINCY, IL 62306-0847
(217) 221-5615
(217) 221-5915
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054017868
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1486390
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/18/2012
Last updated
09/27/2021
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