Organization
DEAN HEALTH SYSTEMS, INC.
Active
Parent organization
DEAN HEALTH SYSTEMS, INC.
Other names
LANDS END EXPRESS CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DEAN HEALTH SYSTEMS, INC.
Authorized official
AMY J GRINNELL (VICE PRESIDENT - FINANCE)
(608) 260-3586
Entity
Organization
Contact information
Practice address
9 LANDS END LN, STE 1, DODGEVILLE, WI 53595-0001
(608) 935-6577
(608) 935-6500
Mailing address
9 LANDS END LN, STE 1, DODGEVILLE, WI 53595-0001
(608) 935-6577
(608) 935-6500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32780900
—
WI
01
—
391628491086
TRICARE
WI
01
—
391628491293
BLUE CROSS BLUE SHIELD
WI
01
—
391628491BL
WPS
WI
01
—
574140
DEAN HEALTH INSURANCE
WI
Enumeration date
03/05/2007
Last updated
08/03/2020
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