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Organization
ROUNDYS SUPERMARKETS INC
Active
Organization
ROUNDYS SUPERMARKETS INC
Active
Other names
COPPS FOOD CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD KITZ (GVP LEGAL AND TREASURY)
(414) 231-5000
Entity
Organization
Contact information
Practice address
3650 UNIVERSITY AVE, MADISON, WI 53705-2143
(608) 231-2533
(608) 232-4246
Mailing address
PO BOX 473, MILWAUKEE, WI 53201-0473
(414) 231-5523
(414) 231-5500
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
8753042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225238926
—
WI
01
—
5130012
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/20/2007
Last updated
04/07/2011
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