# ROUNDYS SUPERMARKETS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** METRO MARKET PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720443146
- **Authorized official:** ALLISON BREDESTEGE (MANAGER OF PHARMACY LICENSING)
- **Authorized official phone:** (513) 762-1019

## Contact information

- **Practice address:** 4075 N OAKLAND AVE, SHOREWOOD, WI 53211-2356
- **Practice address phone:** (414) 962-3744
- **Practice address fax:** (414) 962-3766
- **Mailing address:** PO BOX 842772, BOSTON, MA 02284-2772
- **Mailing address phone:** (513) 762-1019
- **Mailing address fax:** (513) 762-1092

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 9393-42 | WI | Yes |

## Other

- **Enumeration date:** 12/30/2015
- **Last updated:** 12/01/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2157281 | PK | — |