Organization Name: | ROUNDYS |
NPI Number: | 1215302773 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSAN JAY LINCOLN (STAFF PHARMACIST) |
Mailing Address: | 36903 E Wisconsin Ave Oconomowoc |
State: | WI US |
Postal Code: | 530663144 |
Phone Number: | 2625677938 |
Fax Number: | 2625677994 |
NPI Enumeration Date: | 12/09/2015 |
NPI Last Update Date: | 12/09/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 305S00000X |
License Number: | R9740-40 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Managed Care Organizations |
Taxonomy Classification: | Point of Service |
Taxonomy Specialization: | |
Taxonomy Definition: | This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. |