Organization
ROUNDYS SUPERMARKETS INC
Active
Other names
MARIANO'S PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM DOWLING (VICE PRESIDENT)
(414) 231-5000
Entity
Organization
Contact information
Practice address
25 WAUKEGAN RD, GLENVIEW, IL 60025-5154
(847) 724-4821
(847) 724-4965
Mailing address
PO BOX 473, MILWAUKEE, WI 53201-0473
(414) 231-6153
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2147794
PK
—
Enumeration date
09/08/2014
Last updated
07/11/2016
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