# ROUNDYS SUPERMARKETS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** METRO MARKET PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184772444
- **Authorized official:** ALLISON BREDESTEGE (MANAGER OF PHARMACY LICENSING)
- **Authorized official phone:** (513) 762-1019

## Contact information

- **Practice address:** 1123 N VAN BUREN ST, MILWAUKEE, WI 53202-3269
- **Practice address phone:** (414) 347-9219
- **Practice address fax:** (414) 273-8810
- **Mailing address:** PO BOX 842772, BOSTON, MA 02284-2772
- **Mailing address phone:** (513) 762-1019
- **Mailing address fax:** (513) 762-1092

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 8420042 | WI | Yes |

## Other

- **Enumeration date:** 01/05/2007
- **Last updated:** 12/01/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1184772444 | — | WI |
| 01 | — | 2110210 | PK | — |