Provider Demographics
NPI:1710660386
Name:DYER CO. GOVERNMENT
Entity Type:Organization
Organization Name:DYER CO. GOVERNMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DYER COUNTY MAYOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:QUICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:731-286-7800
Mailing Address - Street 1:P.O. BOX 1360
Mailing Address - Street 2:101 WEST COURT STREET
Mailing Address - City:DYERSBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38024
Mailing Address - Country:US
Mailing Address - Phone:731-286-7800
Mailing Address - Fax:731-286-6462
Practice Address - Street 1:1400 HORNBROOK ST.
Practice Address - Street 2:
Practice Address - City:DYERSBURG
Practice Address - State:TN
Practice Address - Zip Code:38024
Practice Address - Country:US
Practice Address - Phone:731-286-7832
Practice Address - Fax:731-286-7836
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DYER CO. GOVERNMENT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-10
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN00023101OtherUNITED HEALTHCARE
TN4263551OtherTENN-CARE-BLUECARE