Organization
ROUNDYS SUPERMARKETS INC
Active
Other names
PICK N SAVE 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
2400 W WISCONSIN AVE, GRAND CHUTE, WI 54914-3109
(920) 831-0400
(920) 831-0322
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
8982-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982931986
—
WI
01
—
2122746
PK
—
Enumeration date
11/11/2009
Last updated
12/01/2016
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