Healthcare Provider Details

I. General information

NPI: 1285678391
Provider Name (Legal Business Name): DEAN HEALTH SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 08/03/2020
Certification Date: 08/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 BROADWAY
WISCONSIN DELLS WI
53965-1358
US

IV. Provider business mailing address

1310 BROADWAY
WISCONSIN DELLS WI
53965-1358
US

V. Phone/Fax

Practice location:
  • Phone: 608-253-1171
  • Fax: 608-253-8012
Mailing address:
  • Phone: 608-253-1171
  • Fax: 608-253-8012

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: 608-294-6218