Provider Demographics
NPI:1154800969
Name:NIEMANN FOODS INC
Entity type:Organization
Organization Name:NIEMANN FOODS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:AWERKAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-221-5615
Mailing Address - Street 1:1501 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-1916
Mailing Address - Country:US
Mailing Address - Phone:217-221-5615
Mailing Address - Fax:217-221-5915
Practice Address - Street 1:1501 S DIRKSEN PKWY
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62703-2128
Practice Address - Country:US
Practice Address - Phone:217-525-2372
Practice Address - Fax:217-527-8416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-13
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy