Provider Information for 1780794479
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DEAN RETAIL SERVICES, INC.
Other Names:Doing Business As:SSM HEALTH PHARMACYOrganization Subpart: YES
NPI: 1780794479
Last Updated: 2023-10-25
Certification Date: 2023-10-25
Certification Date: 2023-10-25
Details
Name | Value | ||||||||
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NPI | 1780794479 | ||||||||
Enumeration Date | 2006-08-30 | ||||||||
NPI Type | NPI-2 Organization | ||||||||
Status | Active | ||||||||
Authorized Official Information | Name: AMY JO GRINNELL Title: VP FINANCE Phone: 6082603586 | ||||||||
Mailing Address | P.O. BOX 259443 ATTN: SSM HEALTH PHARMACY ADMIN MADISON, WI 53725-9443 United States Phone: 608-250-1450 | Fax:608-824-2690 | ||||||||
Primary Practice Address | 752 N. HIGH POINT RD SUITE 300 MADISON, WI 53717-2236 United States Phone: 608-824-4500 | Fax:608-824-4928 | ||||||||
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