ROUNDYS SUPERMARKETS INC (NPI# 1174778120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174778120 |
| Entity Type | Organization |
| Organization Name | ROUNDYS SUPERMARKETS INC |
| Other Organization Name | PICK N SAVE PHARMACY |
| Practice Address |
5851 S Packard Ave Cudahy WI 53110-2615 |
| Mailing Address |
Po Box 842772 Boston MA 02284-2772 |
| Practice Telephone | 4147446058 |
| Practice Fax Number | 4147446141 |
| Mailing Telephone | 5137621019 |
| Mailing Fax Number | 5137621092 |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2018-07-19 |
| Authorized Official Name | ALLISON BREDESTEGE (MANAGER OF PHARMACY LICENSING) |
| Authorized Official Telephone | 5137621019 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 333600000X | Pharmacy | Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
8893-042 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2117886 | 01 | |
| WI | 1174778120 | 05 |
| Other Name | Type Code |
|---|---|
| PICK N SAVE PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083181960 | Roundys Supermarkets Inc | Durable Medical Equipment & Medical Supplies | 205 Central Bridge St, Wausau, WI 54401-2947 | 2018-10-29 |
| 1124568894 | Roundys Supermarkets Inc | Durable Medical Equipment & Medical Supplies | 2201 Miller Park Way, West Milwaukee, WI 53219-1643 | 2017-03-01 |
| 1497292692 | Roundys Supermarkets Inc | Pharmacy | 10 E Golf Rd, Des Plaines, IL 60016-2228 | 2017-01-25 |
| 1013464619 | Roundys Supermarkets Inc | Pharmacy | 3857 S Dr Martin Luther King Jr Dr, Chicago, IL 60653 | 2016-09-01 |
| 1184074916 | Roundys Supermarkets Inc | Pharmacy | 3030 N Broadway St, Suite 100, Chicago, IL 60657-5316 | 2016-06-13 |
| 1720443146 | Roundys Supermarkets Inc | Pharmacy | 4075 N Oakland Ave, Shorewood, WI 53211-2356 | 2015-12-30 |
| 1548625551 | Roundys Supermarkets Inc | Pharmacy | 9504 142nd Street, Orland Park, IL 60462 | 2015-12-17 |
| 1689059024 | Roundys Supermarkets Inc | Pharmacy | 784 Skokie Blvd, Northbrook, IL 60062 | 2015-07-28 |
| 1770976102 | Roundys Supermarkets Inc | Pharmacy | 3358 W Touhy Ave, Skokie, IL 60076 | 2015-03-10 |
| 1447651674 | Roundys Supermarkets Inc | Pharmacy | 25 Waukegan Rd, Glenview, IL 60025-5154 | 2014-09-08 |
| Street Address |
5851 S PACKARD AVE |
| City | CUDAHY |
| State | WI |
| Zip Code | 53110-2615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295108967 | Nicholas Stack | Pharmacist | 5851 S Packard Ave, Cudahy, WI 53110-2615 | 2015-11-03 |
| 1659778710 | Harold Krueger | Pharmacist | 5851 S Packard Ave, Cudahy, WI 53110-2615 | 2014-12-04 |
| 1033515044 | Yousef Hasan | Pharmacist | 5851 S Packard Ave, Cudahy, WI 53110-2615 | 2014-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164059150 | Access Mobility Vans, Inc. | Durable Medical Equipment & Medical Supplies | 1995 E. Norse Ave., Cudahy, WI 53110 | 2020-03-27 |
| 1497191357 | Kristel Roebbeke | Occupational Therapist | 4157 W College Ave, Milwaukee, WI 53110 | 2013-05-20 |
| 1568684058 | City of Cudahy | Case Management | 5050 South Lake Drive, Cudahy, WI 53110 | 2007-05-03 |
| 1104854363 | Mathew George Mathai | Internal Medicine | 5900 S. Lake Dr., Cudahy, WI 53110 | 2006-06-28 |
| 1174917199 | Alyssa Kaleta | Internal Medicine | 5900 S Lake Dr, Cudahy, WI 53110 | 2015-03-27 |
| 1740546829 | Fatima Ali | Family Medicine | 5900 S Lake Dr, Cudahy, WI 53110 | 2012-04-03 |
| 1609003508 | Elizabeth A Vissat | Podiatrist | 5900 S Lake Dr, 2 West, Cudahy, WI 53110 | 2009-06-18 |
| 1366616864 | Miguel A Aguilera | Anesthesiology | 5900 S Lake Dr, Cudahy, WI 53110 | 2008-04-15 |
| 1235355983 | Aurora Health Care Metro, Inc. | Clinic/Center | 5900 S Lake Drive, Cudahy, WI 53110 | 2007-04-18 |
| 1114005618 | Manila Sodhi | Internal Medicine | 5900 S Lake Dr, 2 West, Cudahy, WI 53110 | 2006-11-01 |
| Find all providers in zip 53110 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730659962 | Hayat Pharmacy 12 | Pharmacy | 5911 S Packard Ave, Cudahy, WI 53110-3025 | 2018-11-30 |
| 1346281219 | Wisconsin Cvs Pharmacy LLC | Pharmacy | 5740 S Packard Ave, Cudahy, WI 53110-2659 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942816939 | The Duluth Clinic, Ltd. | Pharmacy | 204 Belknap St, Ste 100, Superior, WI 54880-2964 | 2020-09-16 |
| 1902417207 | Ipack Pharmacy LLC | Pharmacy | 17000 W North Ave Ste 108w, Brookfield, WI 53005-4423 | 2020-08-11 |
| 1851939037 | Ascension Wisconsin Pharmacy, Inc | Pharmacy | 10180 Washington Ave Ste 102, Mount Pleasant, WI 53177-1604 | 2019-12-18 |
| 1558906354 | Life Change Rx 4 LLC | Pharmacy | 6300 N 76th St Ste 246, Milwaukee, WI 53218-1208 | 2019-11-15 |
| 1285278978 | Life Change Rx 3 LLC | Pharmacy | 7115 W Capitol Dr, Milwaukee, WI 53216-2051 | 2019-11-05 |
| 1295377703 | Hayat Pharmacy 21 LLC. | Pharmacy | 2333 Northwestern Ave Ste 120, Racine, WI 53404-2520 | 2019-10-16 |
| 1487296737 | Xperience Pharmacy LLC | Pharmacy | 5715 W Appleton Ave, Milwaukee, WI 53210-2250 | 2019-10-08 |
| 1962053421 | Hayat Pharmacy 19 LLC | Pharmacy | 805 W. Layton Ave. Suite A, Milwaukee, WI 53221 | 2019-09-26 |
| 1275182925 | Walgreen Co | Pharmacy | 2265 N Mayfair Rd, Wauwatosa, WI 53226-2207 | 2019-09-05 |
| 1982257200 | Hayat Pharmacy 16 LLC | Pharmacy | 603 N 36th St, Milwaukee, WI 53208-3826 | 2019-07-17 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.