Organization
NIEMANN FOODS INC
Active
Other names
County Market Pharmacy 458
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER NIEMANN (EVP/CFO)
(217) 221-5615
Entity
Organization
Contact information
Practice address
518 S MAIN ST, LEWISTOWN, IL 61542-1565
(309) 547-3731
(309) 547-2040
Mailing address
PO BOX 847, QUINCY, IL 62306-0847
(217) 221-5615
(217) 221-5915
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054017962
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2134858
PK
—
Enumeration date
04/25/2012
Last updated
11/25/2020
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