Organization
ROUNDYS SUPERMARKETS INC
Active
Other names
MARIANOS PHARMACY #8539
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM DOWLING (VICE PRESIDENT)
(414) 231-5000
Entity
Organization
Contact information
Practice address
3857 S DR MARTIN LUTHER KING JR DR, CHICAGO, IL 60653
(773) 268-2862
(773) 268-2905
Mailing address
PO BOX 473, MS-2870, MILWAUKEE, WI 53201-0473
(414) 231-5523
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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