# ROUNDYS SUPERMARKETS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** COPPS FOOD CENTER PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225238926
- **Authorized official:** EDWARD KITZ (GVP LEGAL AND TREASURY)
- **Authorized official phone:** (414) 231-5000

## Contact information

- **Practice address:** 3650 UNIVERSITY AVE, MADISON, WI 53705-2143
- **Practice address phone:** (608) 231-2533
- **Practice address fax:** (608) 232-4246
- **Mailing address:** PO BOX 473, MILWAUKEE, WI 53201-0473
- **Mailing address phone:** (414) 231-5523
- **Mailing address fax:** (414) 231-5500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 8753042 | WI | Yes |

## Other

- **Enumeration date:** 07/20/2007
- **Last updated:** 04/07/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1225238926 | — | WI |
| 01 | — | 5130012 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |