Provider Demographics
NPI:1225203847
Name:DICKSON MEDICAL EQUIPMENT, INC.
Entity Type:Organization
Organization Name:DICKSON MEDICAL EQUIPMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:SHIFLET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-446-7444
Mailing Address - Street 1:760 HWY 46 S
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-2556
Mailing Address - Country:US
Mailing Address - Phone:615-446-7444
Mailing Address - Fax:615-446-7483
Practice Address - Street 1:117 N CONALCO DR
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3663
Practice Address - Country:US
Practice Address - Phone:731-660-5080
Practice Address - Fax:731-660-0025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000710332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies