Healthcare Provider Details

I. General information

NPI: 1710903828
Provider Name (Legal Business Name): DEAN HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 08/03/2020
Certification Date: 08/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1626 TUTTLE ST
BARABOO WI
53913
US

IV. Provider business mailing address

1626 TUTTLE ST
BARABOO WI
53913
US

V. Phone/Fax

Practice location:
  • Phone: 608-355-2145
  • Fax:
Mailing address:
  • Phone: 608-355-2145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateWI

VIII. Authorized Official

Name: AMY J GRINNELL
Title or Position: VICE PRESIDENT-FINANCE
Credential:
Phone: 608-260-3586