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Organization
ROUNDY'S SUPERMARKETS INC
Active
Organization
ROUNDY'S SUPERMARKETS INC
Active
Other names
Mariano's Pharmacy 8542
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON BREDESTEGE (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
2999 WAUKEGAN RD, BANNOCKBURN, IL 60015-1538
(414) 231-5959
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Enumeration date
08/17/2017
Last updated
08/17/2017
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