Organization
ST. MARYS DEAN VENTURES INC.
Active
Parent organization
ST. MARYS DEAN VENTURES INC.
Other names
WAUPUN CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. MARYS DEAN VENTURES INC.
Authorized official
AMY J GRINNALL (CHIEF FINANCIAL OFFICE)
(608) 260-3586
Entity
Organization
Contact information
Practice address
612 W BROWN ST, WAUPUN, WI 53963-1702
(920) 324-5043
(920) 324-6768
Mailing address
612 W BROWN ST, WAUPUN, WI 53963-1702
(920) 324-5043
(920) 324-6768
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
137082535
OFFICE OF WORKERS COMP
WI
05
—
32824600
—
WI
01
—
N65
DEAN HEALTH INSURANCE
WI
Enumeration date
06/16/2006
Last updated
10/29/2021
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