Organization
ROUNDYS SUPERMARKETS INC
Active
Other names
METRO MARKET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON BREDESTEGE (MANAGER OF PHARMACY LICENSING)
(513) 762-1019
Entity
Organization
Contact information
Practice address
4075 N OAKLAND AVE, SHOREWOOD, WI 53211-2356
(414) 962-3744
(414) 962-3766
Mailing address
PO BOX 842772, BOSTON, MA 02284-2772
(513) 762-1019
(513) 762-1092
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
9393-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2157281
PK
—
Enumeration date
12/30/2015
Last updated
12/01/2016
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