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Organization
DEAN RETAIL SERVICES INC
Active
Organization
DEAN RETAIL SERVICES INC
Active
Other names
SSM Health Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
AMY JO GRINNELL (VP FINANCE)
(608) 260-3586
Entity
Organization
Contact information
Practice address
700 S PARK ST, SUITE 300, MADISON, WI 53715-1830
(608) 256-6465
(608) 256-6460
Mailing address
P. O. BOX 259443, ATTN: SSM HEALTH PHARMACY ADMIN, MADISON, WI 53725-9443
(608) 250-1450
(608) 824-2690
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
8338-42
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2108737
PK
—
05
—
33271500
—
WI
Enumeration date
09/05/2006
Last updated
09/19/2024
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