Roundys Supermarkets Inc
Organization Active NPI Community/Retail Pharmacy · Vernon Hills, IL
NPI 1992097174 · NPPES record last updated Jul 11, 2016
Key facts
- NPI
- 1992097174
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 054017623 (IL)
- Legal business name
- ROUNDYS SUPERMARKETS INC
- Practice address
- 1720 N Milwaukee Ave
Vernon Hills, IL 60061-1538 - Phone
- (847) 816-3247
- NPI assigned
- May 6, 2011
- Organization subpart
- No
Authorized official
- Name
- William Dowling
- Title
- Vice President
- Phone
- (414) 231-5000
Other NPIs on the same Medicare enrollment 41
Corporate family (same tax ID) 12
Member of 3
Laboratory certificates & supplier records
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Roundys Supermarkets Inc |
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 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL
Medicare enrollment records
| 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… |
| O20120119000246 | IL | DME Supplier - Pharmacy | 5698858470 | Practice locations: Vernon Hills, IL |
National Provider Directory
- Tax ID family
- Mariano'S Pharmacy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 054017623 | IL | Yes |
Addresses
Primary practice location
1720 N Milwaukee Ave
Vernon Hills, IL 60061-1538
Mailing address
PO Box 473
Ms-2870
Milwaukee, WI 53201-0473
Phone (414) 231-5523
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2130170 | Other | PK |
Other names
- MARIANOS PHARMACY
Other providers in Vernon Hills, IL
- Heather Rosenberg
- Laura Beth Rosenberg
- Ronald Rosenthal
- Stephanie Gail Ross, LCSW
- Laura Kristine Rosten
- Kirsten Ariana Rous
- June A Rowley
- Royal Dental
- Marisa Nicole Rubalcava
- Joyce Rubinstein
All providers in Vernon Hills, IL · Community/Retail Pharmacy in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.