Active NPI
Roundys Supermarkets Inc
- Community/Retail Pharmacy
- Northbrook, IL
National Provider Identifier
1356720486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- ROUNDYS SUPERMARKETS INC
- Practice address
- 2323 Capital Dr
Northbrook, IL 60062-6144 - Phone
- (847) 272-2877
- Fax
- (847) 272-2712
- NPI assigned
- May 21, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- William Dowling
- Title
- Vice President
- Phone
- (414) 231-5000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Primary |
Addresses
Primary practice location
2323 Capital Dr
Northbrook, IL 60062-6144
Mailing address
PO Box 473
Ms-2870
Milwaukee, WI 53201-0473
Phone (414) 231-6153
Other names 1
- MARIANO'S PHARMACY #8532
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110329000044 | IL | Part B Supplier - Mass Immunization (Roster Biller Only) | 5698858470 |
41 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Skokie, IL; Harwood Heights, IL; Hoffman Estates, IL; Lake Zurich, IL; Lombard, IL; Gurnee, IL; Naperville, IL; Northbrook, IL… |
Other NPIs on the same Medicare enrollment 41
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Community/Retail Pharmacy
- Hoffman Estates, IL
- NPI 1134484389
O20110329000044
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2115364 | Mariano'S Pharmacy | Certificate of waiver | Jul 5, 2026 |
National Provider Directory
National Provider DirectoryMember of 3
Organizations this organization is a member of, according to the National Provider Directory.
Locations
2323 Capital Dr
Northbrook, IL 60062
Phone (847) 272-2877
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432166400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1468195200000",
"number": "1356720486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 473",
"address_2": "MS-2870",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532010473",
"telephone_number": "414-231-6153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2323 CAPITAL DR",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600626144",
"telephone_number": "847-272-2877",
"fax_number": "847-272-2712"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROUNDYS SUPERMARKETS INC",
"organizational_subpart": "NO",
"enumeration_date": "2015-05-21",
"last_updated": "2016-07-11",
"status": "A",
"authorized_official_last_name": "DOWLING",
"authorized_official_first_name": "WILLIAM",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "414-231-5000"
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "MARIANO'S PHARMACY #8532",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Northbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.