Roundys Supermarkets Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

8714042 Issued in WI

Legal business name

ROUNDYS SUPERMARKETS INC

Practice address

2355 N 35TH St
Milwaukee, WI 53210-3033

Phone

(414) 447-8117

Fax

(414) 447-8365

NPI assigned

Jan 11, 2007

Organization subpart

No

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

Authorized official

Name

Allison Bredestege

Title

Manager of Pharmacy Licensing

Phone

(513) 762-1019

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• PICK N SAVE Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• Roundys Supermarkets Inc

  • Community/Retail Pharmacy
  • Germantown, WI
  • NPI 1629126982

  Member Of

  NPD member
• RBF LLC

  • Community/Retail Pharmacy
  • Oakdale, MN
  • NPI 1639227994

  Member Of

  NPD member
• The Kroger Co

  • Community/Retail Pharmacy
  • Woodstock, GA
  • NPI 1720012560

  Member Of

  NPD member

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480550400000",
    "number": "1386794600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 842772",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022842772",
            "telephone_number": "513-762-1019",
            "fax_number": "513-762-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355 N 35TH ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532103033",
            "telephone_number": "414-447-8117",
            "fax_number": "414-447-8365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUNDYS SUPERMARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2016-12-01",
        "status": "A",
        "authorized_official_last_name": "BREDESTEGE",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "MANAGER OF PHARMACY LICENSING",
        "authorized_official_telephone_number": "513-762-1019"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "8714042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386794600",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2111007",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PICK N SAVE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Round & Round Destination LLC
• Candace D Roundtree
• Roundys
• Roundys Supermarkets Inc
• Roundys Supermarkets Inc
• Roundys Supermarkets Inc
• Roundys Supermarkets Inc
• Roundys Supermarkets Inc
• Roundys Supermarkets Inc
• Roundys Supermarkets Inc

• Community/Retail Pharmacy in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Community/Retail Pharmacy in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 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.

Verify at the official NPI Registry.