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
—
—
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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