Provider Demographics
NPI:1114041761
Name:DIXIE MEDICAL EQUIPMENT INC
Entity type:Organization
Organization Name:DIXIE MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIXIE
Authorized Official - Middle Name:MEYERS
Authorized Official - Last Name:TUCKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-628-6900
Mailing Address - Street 1:430 W SOUTH AVE
Mailing Address - Street 2:P O BOX 909
Mailing Address - City:WINNFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:71483-3424
Mailing Address - Country:US
Mailing Address - Phone:318-628-6900
Mailing Address - Fax:318-628-6111
Practice Address - Street 1:430 W SOUTH AVENUE
Practice Address - Street 2:BOX 909
Practice Address - City:WINNFIELD
Practice Address - State:LA
Practice Address - Zip Code:71483-3424
Practice Address - Country:US
Practice Address - Phone:318-628-6900
Practice Address - Fax:318-628-6111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332BX2000X
LA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5950750001Medicare NSC