Provider Demographics
NPI:1407993447
Name:DIXIE HEALTH CARE, INC
Entity Type:Organization
Organization Name:DIXIE HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAM
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-763-7322
Mailing Address - Street 1:851 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 1:606 W KEISER AVE
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:AR
Practice Address - Zip Code:72370-3504
Practice Address - Country:US
Practice Address - Phone:870-563-3833
Practice Address - Fax:870-563-3108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR49201OtherAR BCBS
AR49201OtherAR BCBS