Organization Active NPI

Niedermann Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Marshalltown, IA
National Provider Identifier
1508545344
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
NIEDERMANN PHARMACY, INC.
Practice address
211 W Main St
Marshalltown, IA 50158-5845
Phone
(641) 758-3350
Fax
(641) 758-3351
NPI assigned
Jul 17, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Doug Niedermann, PHARMD
Title
President
Phone
(319) 393-4944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

211 W Main St
Marshalltown, IA 50158-5845

Mailing address

1790 Blairs Ferry Rd
Hiawatha, IA 52233-2033
Phone (319) 393-4944

Other names 1

  • Nied's Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210302000889 IA Part B Supplier - Pharmacy 8729314158 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hiawatha, IA; Marshalltown, IA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Niedermann Pharmacy Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1790 Blairs Ferry Rd
Hiawatha, IA 52233
Phone (319) 378-8362

211 W Main St
Marshalltown, IA 50158
Phone (641) 752-3651

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1689552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1508545344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 BLAIRS FERRY RD",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522332033",
            "telephone_number": "319-393-4944",
            "fax_number": "319-393-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 W MAIN ST",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501585845",
            "telephone_number": "641-758-3350",
            "fax_number": "641-758-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIEDERMANN PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-17",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "NIEDERMANN",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-393-4944",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nied's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Nied's Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marshalltown, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.