# ST. MARYS DEAN VENTURES INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST. MARYS DEAN VENTURES INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1811944093
- **Legal business name:** ST. MARYS DEAN VENTURES INC.
- **Authorized official:** AMY J GRINNELL (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (608) 260-3586

## Contact information

- **Practice address:** 1700 TUTTLE ST, BARABOO, WI 53913-3319
- **Practice address phone:** (888) 968-4681
- **Practice address fax:** (608) 355-7001
- **Mailing address:** 1305 W MAIN ST, WHITEWATER, WI 53190-1503
- **Mailing address phone:** (262) 472-7686
- **Mailing address fax:** (262) 472-7691

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | WI | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | — | WI | — |
| 261QR0200X | Radiology Clinic/Center | — | WI | — |
| 261QR0206X | Mammography Clinic/Center | — | WI | — |
| 291U00000X | Clinical Medical Laboratory | — | WI | — |

## Other

- **Enumeration date:** 05/31/2006
- **Last updated:** 10/29/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0592394 | — | IA |
| 05 | — | 200232380A | — | IN |
| 05 | — | 200403240A | — | IN |
| 05 | — | 32780900 | — | WI |
| 05 | — | 32824600 | — | WI |
| 05 | — | 32829800 | — | WI |
| 05 | — | 32882300 | — | WI |
| 05 | — | 5E293GR | — | MN |