ROUNDYS SUPERMARKETS INC NPI 1174778120

NPI Information

  • NPI: 1174778120
  • Provider Name: ROUNDYS SUPERMARKETS INC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • :
  • Address: 5851 S PACKARD AVE
    CUDAHY, WI
    ZIP 53110
  • Phone: (414) 744-6058

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NPI Details

ROUNDYS SUPERMARKETS INC is a community/retail pharmacy pharmacy in Cudahy, 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 1174778120. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

5851 S PACKARD AVE
CUDAHY, WI
ZIP 53110-615
Phone: (414) 744-6058
Fax: (414) 744-6141

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 enumeration date for this NPI number is 11/18/2008 and was last updated on 9/19/2025.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail Pharmacy8893-042WISCONSINYes

Other Identifiers

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

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12117886OTHERPK
21174778120MEDICAIDWISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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