Organization
ROUNDYS SUPERMARKETS INC
Active
Other names
COPPS FOOD CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD KITZ (GVP LEGAL AND TREASURY)
(414) 231-5000
Entity
Organization
Contact information
Practice address
3650 UNIVERSITY AVE, MADISON, WI 53705-2143
(608) 231-2533
(608) 232-4246
Mailing address
PO BOX 473, MILWAUKEE, WI 53201-0473
(414) 231-5523
(414) 231-5500
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
8753042
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225238926
—
WI
01
—
5130012
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/20/2007
Last updated
04/07/2011
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