Provider Demographics
NPI:1447326764
Name:DIXIE HEALTH CARE, INC
Entity type:Organization
Organization Name:DIXIE HEALTH CARE, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-763-7322
Mailing Address - Street 1:839 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BLYTHEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72315-2521
Mailing Address - Country:US
Mailing Address - Phone:870-763-7322
Mailing Address - Fax:870-763-7420
Practice Address - Street 1:839 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BLYTHEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72315-2521
Practice Address - Country:US
Practice Address - Phone:870-763-7322
Practice Address - Fax:870-763-7420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR103495716Medicaid
AR49201OtherBLUE CROSS BLUE SHIELD
MO621155506Medicaid
AR0232900001Medicare NSC