Provider Demographics
NPI:1851851141
Name:DEAN RETAIL SERVICES, INC.
Entity Type:Organization
Organization Name:DEAN RETAIL SERVICES, INC.
Other - Org Name:SSM HEALTH PRESCRIPTION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:GRINNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-260-3586
Mailing Address - Street 1:P.O. BOX 259443
Mailing Address - Street 2:ATTN: SSM HEALTH PHARMACY ADMIN
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53725-9443
Mailing Address - Country:US
Mailing Address - Phone:608-250-1450
Mailing Address - Fax:608-824-2690
Practice Address - Street 1:740 REENA AVE STE 300
Practice Address - Street 2:
Practice Address - City:FORT ATKINSON
Practice Address - State:WI
Practice Address - Zip Code:53538-3145
Practice Address - Country:US
Practice Address - Phone:920-568-3515
Practice Address - Fax:920-568-3513
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEAN HEALTH SYSTEMS, INC,
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-22
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy