NPIMap

Organization Active NPI

Roundys

  • Community/Retail Pharmacy
  • Milwaukee, WI
National Provider Identifier
1104298595
Registry record updated Oct 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
18206-40 Issued in WI
Legal business name
ROUNDYS
Practice address
875 E Wisconsin Ave
Milwaukee, WI 53202-5404
Phone
(414) 308-3046
NPI assigned
Oct 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Steve Shuda
Title
Manager
Phone
(414) 308-3046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 18206-40 WI Primary

Addresses

Primary practice location

875 E Wisconsin Ave
Milwaukee, WI 53202-5404

Mailing address

875 E Wisconsin Ave
Milwaukee, WI 53202-5404

National Provider Directory

National Provider Directory

Locations

875 E Wisconsin Ave
Milwaukee, WI 53202
Phone (414) 231-5000

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445558400000",
    "number": "1104298595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 E WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532025404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 E WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532025404",
            "telephone_number": "414-308-3046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUNDYS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-23",
        "last_updated": "2015-10-23",
        "status": "A",
        "authorized_official_last_name": "SHUDA",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "414-308-3046"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "18206-40",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.