Organization
DEAN HEALTH SYSTEMS, INC
Active
Other names
SSM Health Dean Medical Group - Portage
Organization subpart
No
Provider details
NPI number
Authorized official
AMY J GRINNELL (VICE PRESIDENT - FINANCE)
(608) 260-3586
Entity
Organization
Contact information
Practice address
2825 HUNTERS TRL, 2ND FLOOR, PORTAGE, WI 53901
(608) 742-1063
(608) 745-3750
Mailing address
2825 HUNTERS TRL, 2ND FLOOR, PORTAGE, WI 53901-3429
(608) 742-1063
(608) 745-3750
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053358846
—
WI
Enumeration date
08/31/2006
Last updated
08/03/2020
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