# ROUNDYS SUPERMARKETS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MARIANO'S PHARMACY \#8534
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659741239
- **Authorized official:** WILLIAM DOWLING (VICE PRESIDENT)
- **Authorized official phone:** (414) 231-5000

## Contact information

- **Practice address:** 1500 N CLYBOURN AVE, \#C104, CHICAGO, IL 60610-2295
- **Practice address phone:** (312) 475-9691
- **Practice address fax:** (312) 475-9688
- **Mailing address:** PO BOX 473, MS-2870, MILWAUKEE, WI 53201-0473
- **Mailing address phone:** (414) 231-6153

## Taxonomy

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

## Other

- **Enumeration date:** 09/25/2015
- **Last updated:** 07/11/2016