NPIMap

Organization Active NPI

Dean Retail Services Inc

Doing business as SSM Health Pharmacy

  • Community/Retail Pharmacy
  • Madison, WI
National Provider Identifier
1164524567
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
8338-42 Issued in WI
Legal business name
DEAN RETAIL SERVICES INC
Doing business as
SSM Health Pharmacy
Practice address
700 S Park St
Suite 300
Madison, WI 53715-1830
Phone
(608) 256-6465
Fax
(608) 256-6460
NPI assigned
Sep 5, 2006
Last updated
Sep 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Amy Jo Grinnell
Title
VP Finance
Phone
(608) 260-3586

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 8338-42 WI Primary

Addresses

Primary practice location

700 S Park St
Suite 300
Madison, WI 53715-1830

Mailing address

P. O. Box 259443
Attn: SSM Health Pharmacy Admin
Madison, WI 53725-9443
Phone (608) 250-1450

Other names 1

  • SSM Health Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930038999 WI DME Supplier - Pharmacy 5395863773 Practice locations: Madison, WI
O20130614000506 WI Part B Supplier - Mass Immunization (Roster Biller Only) 5395863773 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Madison, WI; Janesville, WI

Other NPIs with the same Medicare PAC ID 20

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 20

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
SSM Health Prescription Center700 S Park St, Madison, WI 53715-1830(608) 256-6465 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Blood Glucose Monitors/Supplies (Non-Mail Order) Accepts assignmentParticipating since Jan 1, 2013

National Provider Directory

National Provider Directory
Tax ID family
Dean Eye Care-Lancaster21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1277 Deming Way
Madison, WI 53717
Phone (608) 827-4044

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1164524567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P. O. BOX 259443",
            "address_2": "ATTN: SSM HEALTH PHARMACY ADMIN",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537259443",
            "telephone_number": "608-250-1450",
            "fax_number": "608-824-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 S PARK ST",
            "address_2": "SUITE 300",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537151830",
            "telephone_number": "608-256-6465",
            "fax_number": "608-256-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEAN RETAIL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "GRINNELL",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "608-260-3586"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WI",
            "license": "8338-42",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.