# ROUNDYS SUPERMARKETS INC

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

## Provider details

- **NPI number:** 1992097174
- **Authorized official:** WILLIAM DOWLING (VICE PRESIDENT)
- **Authorized official phone:** (414) 231-5000

## Contact information

- **Practice address:** 1720 N MILWAUKEE AVE, VERNON HILLS, IL 60061-1538
- **Practice address phone:** (847) 816-3247
- **Mailing address:** PO BOX 473, MS-2870, MILWAUKEE, WI 53201-0473
- **Mailing address phone:** (414) 231-5523

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 054017623 | IL | Yes |

## Other

- **Enumeration date:** 05/06/2011
- **Last updated:** 07/11/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2130170 | PK | — |