NPIMap

Roundys Supermarkets Inc

Organization Active NPI Community/Retail Pharmacy · Harwood Heights, IL

NPI 1629319488 · NPPES record last updated Aug 8, 2013

Key facts

NPI
1629319488
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
054.018188 (IL)
Legal business name
ROUNDYS SUPERMARKETS INC
Practice address
7401 W Lawrence Ave
Harwood Heights, IL 60706-3411
Phone
(708) 867-8564
NPI assigned
Mar 4, 2013
Organization subpart
No

Authorized official

Name
Edward Kitz
Title
Group VP-Legal Risk & Treasury
Phone
(414) 231-5000

Other NPIs on the same Medicare enrollment 41

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 41

Corporate family (same tax ID) 23

Organizations that report the same tax identification number in the National Provider Directory.

Member of 3

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

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2036123Mariano'S Pharmacy #8510
7401 W Lawrence Ave, Harwood Heights, IL 60706		Certificate of waiverJan 31, 2028

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Roundys Supermarkets Inc
7401W Lawrence Ave, Harwood Heights, IL 60706-3411 · (708) 867-8564		 Immunosuppressive Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Canes and/or Crutches|Walkers|Ostomy Supplies|Urological Supplies|Enteral Nutrients|Enteral Equipment and/or Supplies|Nebulizer Equipment a… Accepts assignment
Participating since Dec 18, 2023

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in IL

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
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…
O20130606000767 IL DME Supplier - Pharmacy 5698858470 Practice locations: Harwood Heights, IL

National Provider Directory

Tax ID family
Mariano'S Pharmacy (103 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054.018188 IL Yes

Addresses

Primary practice location

7401 W Lawrence Ave
Harwood Heights, IL 60706-3411

Mailing address

PO Box 473
Ms-2870
Milwaukee, WI 53201-0473
Phone (414) 231-5523

Other identifiers

IdentifierTypeStateIssuer
2139244OtherPK

Other names

  • MARIANO'S PHARMACY Doing business as

Other providers in Harwood Heights, IL

All providers in Harwood Heights, IL · Community/Retail Pharmacy in Illinois

Sources for this page

Verify at the official NPI Registry.