NPIMap

Organization Active NPI

Dean Retail Services, Inc.

Doing business as SSM Health Prescription Center

  • Community/Retail Pharmacy
  • Sun Prairie, WI
National Provider Identifier
1467562157
Registry record updated Dec 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
DEAN RETAIL SERVICES, INC.
Doing business as
SSM Health Prescription Center
Practice address
10 Tower Dr
Suite 300
Sun Prairie, WI 53590-1239
Phone
(608) 825-3690
Fax
(608) 825-3665
NPI assigned
Aug 30, 2006
Last updated
Dec 6, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
DEAN HEALTH SYSTEMS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 6, 2022

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

10 Tower Dr
Suite 300
Sun Prairie, WI 53590-1239

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
33271500MedicaidWI

Other names 1

  • SSM Health Prescription Center Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930013973 WI DME Supplier - Pharmacy 5395863773 Practice locations: Sun Prairie, WI
O20130614000506 WI Part B Supplier - Mass Immunization (Roster Biller Only) 5395863773 6 other NPIs on this 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.

National Provider Directory

National Provider Directory
Part of
Dean Medical Center

Member of 1

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

Locations

1700 Tuttle St
Ste 300
Baraboo, WI 53913
Phone (608) 356-6966

305 Elaines Ct
Ste 200
Dodgeville, WI 53533
Phone (608) 930-7311

740 Reena Ave
Ste 200
Fort Atkinson, WI 53538
Phone (920) 563-8468

740 Reena Ave
Ste 300
Fort Atkinson, WI 53538
Phone (920) 568-3515

580 N Washington St
Ste 200
Janesville, WI 53548
Phone (608) 755-3669

1211 Fish Hatchery Rd
Ste 300
Madison, WI 53715
Phone (608) 252-8044

310 Integrity Dr
Madison, WI 53717
Phone (855) 847-3553

700 S Park St
Ste 300
Madison, WI 53715
Phone (608) 256-6465

752 N High Point Rd
Ste 300
Madison, WI 53717
Phone (608) 824-4500

753 N Main St
Ste 300
Oregon, WI 53575
Phone (608) 835-7175

2825 Hunters Trl
Ste 200
Portage, WI 53901
Phone (608) 745-3833

2825 Hunters Trl
Ste 300
Portage, WI 53901
Phone (608) 745-3001

225 Church St
Ste 200
Stoughton, WI 53589
Phone (608) 877-2710

10 Tower Dr
Ste 200
Sun Prairie, WI 53590
Phone (608) 825-3505

10 Tower Dr
Ste 300
Sun Prairie, WI 53590
Phone (608) 825-3690

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1467562157",
    "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": "10 TOWER DR",
            "address_2": "SUITE 300",
            "city": "SUN PRAIRIE",
            "state": "WI",
            "postal_code": "535901239",
            "telephone_number": "608-825-3690",
            "fax_number": "608-825-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEAN RETAIL SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEAN HEALTH SYSTEMS, INC.",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "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": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33271500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SSM Health Prescription Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SSM Health Prescription Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sun Prairie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.