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Organization
ROUNDYS SUPERMARKETS INC
Active
Organization
ROUNDYS SUPERMARKETS INC
Active
Other names
METRO MARKET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON BREDESTEGE (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
4075 N OAKLAND AVE, SHOREWOOD, WI 53211-2356
(414) 962-3744
(414) 962-3766
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
9393-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2157281
PK
—
Enumeration date
12/30/2015
Last updated
12/01/2016
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