Organization
ROUNDYS SUPERMARKETS INC
Active
Other names
MARIANO'S
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM DOWLING (VICE PRESIDENT)
(414) 231-5000
Entity
Organization
Contact information
Practice address
11000 S CICERO AVE, OAK LAWN, IL 60453-5504
(708) 346-0726
(708) 346-0755
Mailing address
PO BOX 473, MS-2870, MILWAUKEE, WI 53201-0473
(414) 231-6153
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054.018723
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2147192
PK
—
Enumeration date
08/01/2014
Last updated
07/11/2016
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