Organization Active NPI

Roundys Supermarkets Inc

Doing business as Copps Food Center Pharmacy

  • Community/Retail Pharmacy
  • Stevens Point, WI
National Provider Identifier
1710214713
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
8983-42 Issued in WI
Legal business name
ROUNDYS SUPERMARKETS INC
Doing business as
Copps Food Center Pharmacy
Practice address
3256 Church St
Stevens Point, WI 54481-5321
Phone
(715) 344-6910
Fax
(715) 344-2781
NPI assigned
Nov 11, 2009
Last updated
Apr 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 8983-42 WI Primary

Addresses

Primary practice location

3256 Church St
Stevens Point, WI 54481-5321

Mailing address

PO Box 473
Ms-2870
Milwaukee, WI 53201-0473
Phone (414) 231-6153

Other names 1

  • COPPS FOOD CENTER PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080218000141 WI Part B Supplier - Mass Immunization (Roster Biller Only) 5698858470 This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Member of 2

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

Member organizations 22

Organizations listed as members of this organization in the National Provider Directory.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1257897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302134400000",
    "number": "1710214713",
    "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",
            "fax_number": "414-231-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3256 CHURCH ST",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544815321",
            "telephone_number": "715-344-6910",
            "fax_number": "715-344-2781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUNDYS SUPERMARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-11",
        "last_updated": "2011-04-07",
        "status": "A",
        "authorized_official_last_name": "KITZ",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "GVP - LEGAL RISK & TREASURY",
        "authorized_official_telephone_number": "414-231-5000"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "8983-42",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COPPS FOOD CENTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stevens Point, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.