Provider Demographics
NPI:1144505322
Name:DILLARD'S, INC.
Entity type:Organization
Organization Name:DILLARD'S, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WORLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-376-5420
Mailing Address - Street 1:1600 CANTRELL RD
Mailing Address - Street 2:LEGAL DEPARTMENT
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72201-1110
Mailing Address - Country:US
Mailing Address - Phone:501-376-5894
Mailing Address - Fax:501-210-9610
Practice Address - Street 1:5000 SHELBYVILLE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3342
Practice Address - Country:US
Practice Address - Phone:502-893-4400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-19
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6293860005Medicare NSC