Organization
ROUNDY'S SUPERMARKETS INC
Active
Other names
PICK 'N SAVE PHARMACY #6390
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD GEORGE KITZ (GVP-LEGAL RISK & TREASURY)
(414) 231-5000
Entity
Organization
Contact information
Practice address
1750 HWY 51 W, STOUGHTON, WI 53589
(608) 873-3069
(608) 873-3412
Mailing address
1750 HWY 51 W, STOUGHTON, WI 53589
(608) 873-3069
(608) 873-3412
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
8850-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36229400
—
WI
01
—
5130860
NCPDP
—
Enumeration date
07/28/2008
Last updated
03/15/2010
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