NPI Code Details Logo

NPI 1013730373

NPI 1013730373 : DEAN RETAIL SERVICES INC : PRAIRIE DU SAC, WI

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1013730373
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    DEAN RETAIL SERVICES INC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    11/05/2024
-----------------------------------------------------
    Last Update Date     |    05/19/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1110 PRAIRIE ST STE 200 
-----------------------------------------------------
    City                 |    PRAIRIE DU SAC
-----------------------------------------------------
    State                |    WI
-----------------------------------------------------
    Zip                  |    53578-2044
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    608-644-3815
-----------------------------------------------------
    Fax                  |    608-644-3816
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1808 W BELTLINE HWY 
-----------------------------------------------------
    City                 |    MADISON
-----------------------------------------------------
    State                |    WI
-----------------------------------------------------
    Zip                  |    53713-2334
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    608-294-6218
-----------------------------------------------------
    Fax                  |    608-250-1384
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    VICE PRESIDENT FINANCE
-----------------------------------------------------
    Name                 |     AMY JO GRINNELL 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    608-260-3586
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    332B00000X
-----------------------------------------------------
    Taxonomy Name        |    Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.