Organization
ROUNDY'S SUPERMARKETS, INC
Active
Other names
Mariano's Pharmacy #543
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON BREDESTEGE (MANAGER OF RX LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
345 W ROOSEVELT RD, LOMBARD, IL 60148-4219
(630) 629-4475
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
12/20/2016
Last updated
12/01/2017
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