Provider Demographics
NPI:1629247705
Name:DEAN HEALTH SYSTEMS, INC.
Entity Type:Organization
Organization Name:DEAN HEALTH SYSTEMS, INC.
Other - Org Name:REEDSBURG AREA MEDICAL SPECIALTY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT - FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRINNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-260-3586
Mailing Address - Street 1:1104 21ST ST STE A
Mailing Address - Street 2:
Mailing Address - City:REEDSBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53959-1156
Mailing Address - Country:US
Mailing Address - Phone:608-524-6487
Mailing Address - Fax:608-524-6211
Practice Address - Street 1:1104 21ST ST STE A
Practice Address - Street 2:
Practice Address - City:REEDSBURG
Practice Address - State:WI
Practice Address - Zip Code:53959-1156
Practice Address - Country:US
Practice Address - Phone:608-524-6487
Practice Address - Fax:608-524-6211
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEAN HEALTH SYSTEMS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-22
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI332B00000X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32829800Medicaid
WI32829800Medicaid
WI32829800Medicaid