Organization
ROUNDYS SUPERMARKETS INC
Active
Other names
MARIANO'S PHARMACY #8530
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM DOWLING (VICE PRESIDENT)
(414) 231-5000
Entity
Organization
Contact information
Practice address
2559 W 95TH ST, EVERGREEN PARK, IL 60805
(708) 422-2056
Mailing address
PO BOX 473, MS-2870, MILWAUKEE, WI 53201-0473
(414) 231-5000
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
12/18/2014
Last updated
07/11/2016
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