NPI 1043475379

Roundys Supermarkets INC

Organisation Community/Retail Pharmacy Green Bay, WI

Practice location

Address: 1819 Main St, Green Bay, WI 54302-3918
Phone: (920) 469-3436
Fax: (920) 469-3568
Mailing address: PO Box 842772, Boston, MA 02284-2772

Authorised official

Name: Allison Bredestege
Title: Manager of Pharmacy Licensing
Phone: (513) 762-1019

Registered specialties

Community/Retail Pharmacy Primary

Suppliers Taxonomy 3336C0003X Licence 8859042 (WI)

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Registry record

NPI: 1043475379
Entity type: Organization
NPI issued: 25 Jul 2008
Record last updated: 1 Dec 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.