# JEWEL FOOD STORES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** JEWEL OSCO
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467408971
- **Authorized official:** LORENZO TORRES (NEW STORE ENROLLMENTS)
- **Authorized official phone:** (847) 916-4463

## Contact information

- **Practice address:** 2355 N 35TH ST, MILWAUKEE, WI 53210-3033
- **Practice address phone:** (414) 447-8117
- **Practice address fax:** (414) 447-8365
- **Mailing address:** 2355 N 35TH ST, MILWAUKEE, WI 53210-3033

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 8057 | WI | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 05/26/2006
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 33254000 | — | WI |
| 01 | — | 5126277 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |