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MARIANO'S PHARMACY #543
NPI 1477098978
Pharmacy - Community/Retail Pharmacy in Lombard, IL

Active since December 20, 2016CLIA 14D2166821 · Waiver
345 W ROOSEVELT RD, LOMBARD, IL 60148(630) 629-4475 Get Directions Write a Review

NPPES record last updated: December 1, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 1, 2017, Nov 16, 2017, Dec 20, 2016 (3 updates tracked since 2016).

About Mariano's Pharmacy #543 NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARIANO'S PHARMACY #543 (NPI 1477098978) is a healthcare organization registered as a community/retail pharmacy in Lombard, Illinois and active in the NPI registry since December 2016. The organization holds a CLIA Waiver certificate valid through May 27, 2027 and lists Allison Bredestege, Manager Of Rx Licensing, as its authorized official.

NPPES Registry Identity

NPI1477098978
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameROUNDY'S SUPERMARKETS, INC
Location Address345 W ROOSEVELT RDLombard, IL 60148-4219
Mailing AddressPo Box 842772Boston, MA 02284-2772
Phone(630) 629-4475
Organization SubpartNo
Authorized OfficialAllison BredestegeManager Of Rx Licensing · (513) 762-1019
Enumeration DateDecember 20, 2016
Last NPPES UpdateDecember 1, 20173 updates tracked since enumeration
✔ NPI 1477098978 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition
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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
345 W ROOSEVELT RD, Lombard, IL 60148
Open in Google Maps ↗

Other Names 1

Doing Business AsMariano's Pharmacy #543

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arizona Complete Health and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2166821

Mariano's Pharmacy #543 · Lombard, IL
Active · expires May 27, 2027
CLIA Number14D2166821
Laboratory TypePharmacy
Certificate Effective DateMay 28, 2025
Certificate Expiration DateMay 27, 2027
Laboratory DirectorStacy Doyle
Laboratory Phone(630) 629-4475
Laboratory LocationMariano's Pharmacy #543345 W Roosevelt Rd, Lombard, IL 60148
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
114 services114 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
108 services108 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
14 services14 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
14 services14 patients

Medical Equipment Supplier Medicare DMEPOS 5

Medicare supplier enrollment and the product categories Mariano's Pharmacy #543 carries, from the Medicare DMEPOS supplier directory.

Mariano's Pharmacy #543

DMEPOS supplier · Lombard, ILOperated by Roundys Supermarkets Inc
✔

Accepts Medicare assignment

Mariano's Pharmacy #543 agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20563541
Medicare Participant SinceDecember 18, 2023
Supplier Location345 W Roosevelt RdLombard, IL 60148
Phone(630) 629-4475
Supplier Specialties
Pharmacy

Medicare Product Categories

Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

1918 WINTER STREET OPERATING CO LLC
Pharmacy (Community/Retail Pharmacy)
345 W ROOSEVELT RD
LOMBARD, IL 60148
Dupage County (630) 629-4475
DR. LEONEL MENDIA JR. PHARMD
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
345 W ROOSEVELT RD
LOMBARD, IL 60148
Dupage County (630) 629-4475
KATHLEEN STAPLEY PHARM.D.
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
345 W ROOSEVELT RD
LOMBARD, IL 60148
Dupage County (630) 629-4475

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Roundy's Supermarkets, Inc's NPI number?

The NPI number for Roundy's Supermarkets, Inc is 1477098978. It was assigned to this organization in the NPPES registry on December 20, 2016. The provider is doing business as Mariano's Pharmacy #543.

Where is Roundy's Supermarkets, Inc located?

Roundy's Supermarkets, Inc is located at 345 W Roosevelt Rd, Lombard, IL 60148. The listed phone number is (630) 629-4475.

What is Roundy's Supermarkets, Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Does Roundy's Supermarkets, Inc accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Mariano's Pharmacy #543 accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Roundy's Supermarkets, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2166821) is associated with this NPI, valid through May 27, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Roundy's Supermarkets, Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 46 other insurers list Roundy's Supermarkets, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Roundy's Supermarkets, Inc was last updated on December 1, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.