NPIMap

Organization Active NPI

Roundys Supermarkets Inc

Doing business as Marianos Pharmacy

  • Community/Retail Pharmacy
  • Vernon Hills, IL
National Provider Identifier
1992097174
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
054017623 Issued in IL
Legal business name
ROUNDYS SUPERMARKETS INC
Doing business as
Marianos Pharmacy
Practice address
1720 N Milwaukee Ave
Vernon Hills, IL 60061-1538
Phone
(847) 816-3247
NPI assigned
May 6, 2011
Last updated
Jul 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 054017623 IL Primary

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 names 1

  • MARIANOS PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

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…
O20120119000246 IL DME Supplier - Pharmacy 5698858470 Practice locations: Vernon Hills, IL

Other NPIs on the same Medicare enrollment 41

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

View all 41

Laboratory certificates & supplier records

Derived by NPIMap

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Roundys Supermarkets Inc1720 N Milwaukee Ave, Vernon Hills, IL 60061-1538(847) 816-3247 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 assignmentParticipating since Dec 18, 2023

National Provider Directory

National Provider Directory
Tax ID family
Roundys Supermarkets Inc103 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Member of 3

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

Locations

1720 N Milwaukee Ave
Vernon Hills, IL 60061
Phone (847) 816-3247

NPI Registry JSON

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

{
    "created_epoch": "1304640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468195200000",
    "number": "1992097174",
    "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": "414-231-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 N MILWAUKEE AVE",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611538",
            "telephone_number": "847-816-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUNDYS SUPERMARKETS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-06",
        "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": "IL",
            "license": "054017623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MARIANOS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vernon Hills, 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.

Verify at the official NPI Registry.