Organization
ROUNDYS SUPERMARKETS INC
Active
Other names
COPPS FOOD CENTER 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
1500 PINECREST AVE, STEVENS POINT, WI 54481-4326
(715) 345-7175
(715) 345-1745
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
9140-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255668257
—
WI
01
—
2122745
PK
—
Enumeration date
11/11/2009
Last updated
09/19/2025
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