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Organization

ROUNDYS SUPERMARKETS INC

Active
Other names
PICK N SAVE PHARMACY #53400478
Organization subpart
No

Provider details

NPI number
Authorized official
JESSIE WARMAN (MANAGER RX LICENSING)
(513) 762-1090
Entity
Organization

Contact information

Practice address
1940 S KOELLER ST, OSHKOSH, WI 54902-6200
(920) 236-9494
(920) 236-8876
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
8968-42
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1942537014
WI
01
2122723
PK
Enumeration date
11/11/2009
Last updated
12/17/2019
About Stedi
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  • Eligibility checks
  • EDI platform