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General NPI Number Information
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NPI Number | 1639992985
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Entity Type | Organization
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Legal Business Name | DEAN RETAIL SERVICES, INC.
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Dates
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Enumeration Date | 11/05/2024
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 1626 TUTTLE ST STE 200
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City | BARABOO
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State | WI
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Zip | 53913-1501
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Country | US
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Telephone | 608-355-7070
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Fax | 608-355-7055
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Provider Business Mailing Address
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Address Line | 1808 W BELTLINE HWY
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City | MADISON
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State | WI
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Zip | 53713-2334
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Country | US
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Telephone | 608-294-6218
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | AMY JO GRINNELL
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Credential |
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Telephone | 608-260-3586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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