ROUNDYS SUPERMARKETS INC NPI 1164745162

NPI Details

ROUNDYS SUPERMARKETS INC is a community/retail pharmacy pharmacy in Brookfield, WI. The provider is 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. ROUNDYS SUPERMARKETS INC NPI is 1164745162. The provider is registered as an organization entity type.
The provider Is Doing Business As Metro Market Pharmacy.

The provider's business location address is:

17630 W BLUEMOUND RD
BROOKFIELD, WI
ZIP 53045-908
Phone: (262) 784-2490
Fax: (262) 784-2507

The provider's authorized official is Allison Bredestege .
The authorized official title is Manager Of Pharmacy Licensing and has the following contact phone number (513) 762-1019.

The CLIA number assigned to this NPI record is 52D2155863 - other - pharmacy with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count (HCPCS:K1034)
• Administration of influenza virus vaccine (HCPCS:G0008)
• Influenza vaccine split virus, preservative free (HCPCS:90662)
• Fee covid-19 vac 14 res (HCPCS:0134A)
• Adm sarscv2 30mcg trs-sucr b (HCPCS:0054A)
• Adm sarscov2 50mcg/0.25mlbst (HCPCS:0064A)

The enumeration date for this NPI number is 3/4/2010 and was last updated on 12/1/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.