ST MARY'S DEAN VENTURES INC NPI 1144392275

NPI Information

NPI: 1144392275
Provider Name: ST MARY'S DEAN VENTURES INC

Doing Business As: BREAST CORE BIOPSY CENTER

Classification: Clinic/Center - 261QR0200X
Entity Type: Organization

Specialization: Radiology

Address:
1313 FISH HATCHERY ROAD
MADISON, WI
ZIP 53715
Phone: (608) 252-7445
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ST MARY'S DEAN VENTURES INC is a radiology clinic center in Madison, WI. ST MARY'S DEAN VENTURES INC NPI is 1144392275. The provider is registered as an organization entity type.
The provider Is Doing Business As Breast Core Biopsy Center.

The provider's business location address is:

1313 FISH HATCHERY ROAD
MADISON, WI
ZIP 53715
Phone: (608) 252-7445

The provider's authorized official is Amy J Grinnell .
The authorized official title is Chief Financial Office and has the following contact phone number (608) 260-3586.

The enumeration date for this NPI number is 11/14/2006 and was last updated on 10/29/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0200X	Clinic/Center	Radiology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	543668	OTHER	WISCONSIN	DEAN HEALTH PLAN
2	32837200	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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