Organization
ROUNDYS SUPERMARKETS INC
Active
Other names
PICK N SAVE PHARMACY #121
Organization subpart
No
Provider details
NPI number
Authorized official
JESSIE WARMAN (MANAGER RX LICENSING)
(513) 762-1090
Entity
Organization
Contact information
Practice address
900 E RIVERVIEW EXPY, WISCONSIN RAPIDS, WI 54494-5482
(715) 631-7177
(751) 631-7175
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
8970-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609103605
—
WI
01
—
2122747
PK
—
Enumeration date
11/11/2009
Last updated
10/10/2019
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