NPIMap

Organization Active NPI

Niemann Foods Inc

Doing business as County Market Pharmacy 212

  • Community/Retail Pharmacy
  • Rushville, IL
National Provider Identifier
1821369224
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054017868 Issued in IL
Legal business name
NIEMANN FOODS INC
Doing business as
County Market Pharmacy 212
Practice address
520 W Clinton St
Rushville, IL 62681-1246
Phone
(217) 322-3383
Fax
(217) 322-6033
NPI assigned
Jan 18, 2012
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) 221-5615

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054017868 IL Primary

Addresses

Primary practice location

520 W Clinton St
Rushville, IL 62681-1246

Mailing address

PO Box C847
Quincy, IL 62306-0847
Phone (217) 221-5615

Other identifiers 1

IdentifierTypeStateIssuer
1486390OtherNCPDP PROVIDER IDENTIFICATION NUMBER

Other names 1

  • County Market Pharmacy 212 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
This NPI is an additional NPI on the 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

520 W Clinton St
Rushville, IL 62681
Phone (217) 322-3383

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632700800000",
    "number": "1821369224",
    "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": "217-221-5615",
            "fax_number": "217-221-5915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W CLINTON ST",
            "city": "RUSHVILLE",
            "state": "IL",
            "postal_code": "626811246",
            "telephone_number": "217-322-3383",
            "fax_number": "217-322-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIEMANN FOODS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "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": "217-221-5615"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "IL",
            "license": "054017868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "1486390",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "County Market Pharmacy 212",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "County Market Pharmacy 212",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rushville, 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.