NPIMap

Organization Active NPI

Dean Retail Services, Inc.

Doing business as SSM Health Pharmacy

  • Community/Retail Pharmacy
  • Madison, WI
National Provider Identifier
1780794479
Registry record updated Oct 25, 2023
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 Pharmacy
Practice address
752 N. High Point Rd
Suite 300
Madison, WI 53717-2236
Phone
(608) 824-4500
Fax
(608) 824-4928
NPI assigned
Aug 30, 2006
Last updated
Oct 25, 2023By 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 Oct 25, 2023

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

752 N. High Point Rd
Suite 300
Madison, WI 53717-2236

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
33243500MedicaidWI

Other names 1

  • SSM Health Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 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.

Practitioners & affiliated clinicians

Practitioners 1

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": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1780794479",
    "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": "752 N. HIGH POINT RD",
            "address_2": "SUITE 300",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537172236",
            "telephone_number": "608-824-4500",
            "fax_number": "608-824-4928"
        }
    ],
    "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": "2023-10-25",
        "certification_date": "2023-10-25",
        "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": "33243500",
            "state": "WI"
        }
    ],
    "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 Oct 25, 2023; 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.