ROUNDY'S SUPERMARKETS INC (NPI# 1245495480) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245495480 |
| Entity Type | Organization |
| Organization Name | ROUNDY'S SUPERMARKETS INC |
| Other Organization Name | PICK 'N SAVE PHARMACY #6390 |
| Practice Address |
1750 Hwy 51 W Stoughton WI 53589 |
| Practice Telephone | 6088733069 |
| Practice Fax Number | 6088733412 |
| Mailing Telephone | 6088733069 |
| Mailing Fax Number | 6088733412 |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2010-03-15 |
| Authorized Official Name | EDWARD GEORGE KITZ (GVP-LEGAL RISK & TREASURY) |
| Authorized Official Telephone | 4142315000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | 8850-42 | WI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 5130860 | 01 | |
| WI | 36229400 | 05 |
| Other Name | Type Code |
|---|---|
| PICK 'N SAVE PHARMACY #6390 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659897098 | Roundy's Supermarkets Inc | Durable Medical Equipment & Medical Supplies | 2999 Waukegan Rd, Bannockburn, IL 60015-1538 | 2017-08-17 |
| 1245738814 | Roundy's Supermarkets Inc | Durable Medical Equipment & Medical Supplies | 105 Northwest Hwy, Crystal Lake, IL 60014-7951 | 2018-01-29 |
| Street Address |
1750 HWY 51 W |
| City | STOUGHTON |
| State | WI |
| Zip Code | 53589 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467971507 | Linda Kay Balthazor | Registered Nurse | 900 Truman, Stoughton, WI 53589 | 2017-09-10 |
| 1801342464 | Lorchid Lanoway | Licensed Practical Nurse | 1817 Cedarbrook Ln, Unit 9, Stoughton, WI 53589 | 2016-09-01 |
| 1114203296 | Marilyn Mary Mackinnon | Pharmacist | 1705 Highway Fifty One, Stoughton, WI 53589 | 2011-11-02 |
| 1053693028 | Alfred Bennin | Pharmacist | 1705 Us Hwy 51/138, Stoughton, WI 53589 | 2011-09-15 |
| 1447531892 | Tina Ann Ferguson | Pharmacist | 1705 Us Highway 51, Stoughton, WI 53589 | 2011-08-30 |
| 1285926972 | Jenifer Lee Stokstad | Registered Nurse | 3496 Hwy 138, Stoughton, WI 53589 | 2011-05-12 |
| 1447583018 | Stephanie Marie Kind | Licensed Practical Nurse | 608 W South St, Stoughton, WI 53589 | 2009-09-14 |
| 1386885721 | Scott Tauferner | Physical Therapist | 2300 Us Hwy 51-138, Stoughton, WI 53589 | 2009-03-16 |
| 1720278005 | Judith Davis | Clinical Neuropsychologist | 716 Roby Rd, Stoughton, WI 53589 | 2007-08-01 |
| 1346459609 | Susan Elizabeth Cole Allfrey | Occupational Therapist | 400 North Morris St, Skaalen Sunset Home Inc, Stoughton, WI 53589 | 2007-05-22 |
| Find all providers in zip 53589 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
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|---|---|---|---|---|
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| 1750470365 | White Drug Enterprises Inc | Pharmacy | 101 W Main St, Stoughton, WI 53589-2123 | 2006-10-12 |
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| 1851851141 | Dean Retail Services, Inc. | Pharmacy | 740 Reena Ave Ste 300, Fort Atkinson, WI 53538-3145 | 2019-03-22 |
| 1093287237 | Del Mar Pharmacy Sc | Pharmacy | 1000 S Cesar E Chavez Dr, Milwaukee, WI 53204-2203 | 2018-12-28 |
| 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.