St. Marys Dean Ventures Inc.

Organization Active NPI Durable Medical Equipment & Medical Supplies · Cambria, WI

NPI 1376587337 · NPPES record last updated Oct 29, 2021

Key facts

NPI
1376587337
Entity type
Organization (NPI type 2)
Primary specialty
Durable Medical Equipment & Medical Supplies 332B00000X
Legal business name
ST. MARYS DEAN VENTURES INC.
Practice address
306 E Edgewater St
Cambria, WI 53923-8809
Phone
(920) 348-5114
Fax
(920) 348-5113
NPI assigned
Jun 16, 2006
Organization subpart
Yes
Parent organization (as reported)
ST. MARYS DEAN VENTURES INC.

Authorized official

Name
Amy J Grinnell
Title
Chief Financial Office
Phone
(608) 260-3586

Corporate family (same tax ID) 3

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

National Provider Directory

Tax ID family
Evansville Clinic (4 organizations share this tax ID)
Part of
Evansville Clinic

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X WI Yes

Addresses

Primary practice location

306 E Edgewater St
Cambria, WI 53923-8809

Mailing address

PO Box 24
Cambria, WI 53923-0024
Phone (920) 348-5114

Other identifiers

IdentifierTypeStateIssuer
32824600MedicaidWI
M43OtherWIDEAN HEALTH INSURANCE
137082517OtherWIOFFICE OF WORKERS COMP

Other names

  • AYAZ SAMADANI MD CAMBRIA Doing business as

Other providers in Cambria, WI

All providers in Cambria, WI · Durable Medical Equipment & Medical Supplies in Wisconsin

Sources for this page

Verify at the official NPI Registry.