Organization
ROUNDYS SUPERMARKETS INC
Active
Other names
MARIANO'S PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LYSETTE SEILHAMER (LICENSING MANAGER)
(513) 762-1090
Entity
Organization
Contact information
Practice address
1900 S CUMBERLAND AVE, PARK RIDGE, IL 60068-5235
(847) 696-3846
(847) 696-3486
Mailing address
PO BOX 473, MS-2870, MILWAUKEE, WI 53201-0473
(414) 231-5523
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
054018493
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2143380
PK
—
Enumeration date
12/03/2013
Last updated
08/19/2025
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