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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
17630 W BLUEMOUND RD, BROOKFIELD, WI 53045-2908
(262) 784-2490
(262) 784-2507
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
(513) 762-1092

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
8999-042
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1164745162
WI
01
2123938
PK
Enumeration date
03/04/2010
Last updated
12/01/2016
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