NPIMap

Organization Active NPI

Niemann Foods Inc

Doing business as County Market Pharmacy 026

  • Community/Retail Pharmacy
  • Pittsfield, IL
National Provider Identifier
1619024767
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054016065 Issued in IL
Legal business name
NIEMANN FOODS INC
Doing business as
County Market Pharmacy 026
Practice address
825 W Washington St
Pittsfield, IL 62363-1372
Phone
(217) 285-5515
Fax
(217) 285-1326
NPI assigned
Jan 4, 2007
Last updated
Sep 27, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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

Authorized official

Name
Christopher Niemann
Title
Evp Cfo
Phone
(217) 221-5612

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 054016065 IL Primary

Addresses

Primary practice location

825 W Washington St
Pittsfield, IL 62363-1372

Mailing address

PO Box C847
Quincy, IL 62306-0847
Phone (217) 221-5641

Other identifiers 1

IdentifierTypeStateIssuer
1438200OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • COUNTY MARKET PHARMACY 026 Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211006002600 IL Part B Supplier - Mass Immunization (Roster Biller Only) 6103032206 9 other NPIs on this enrollment
Practice locations: Champaign, IL; Springfield, IL; Pittsfield, IL; Rushville, IL; Chatham, IL; Lewistown, IL

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory

Locations

825 W Washington St
Pittsfield, IL 62363
Phone (217) 285-5515

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1619024767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX C847",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623060847",
            "telephone_number": "217-221-5641",
            "fax_number": "217-221-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 W WASHINGTON ST",
            "city": "PITTSFIELD",
            "state": "IL",
            "postal_code": "623631372",
            "telephone_number": "217-285-5515",
            "fax_number": "217-285-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIEMANN FOODS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A",
        "authorized_official_last_name": "NIEMANN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "EVP CFO",
        "authorized_official_telephone_number": "217-221-5612"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054016065",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1438200",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COUNTY MARKET PHARMACY 026",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Pittsfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; 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.