Provider Demographics
NPI:1871652982
Name:DICKSON MEDICAL EQUIPMENT
Entity Type:Organization
Organization Name:DICKSON MEDICAL EQUIPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:C
Authorized Official - Last Name:SHIFLET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-446-7444
Mailing Address - Street 1:760 HIGHWAY 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:
Practice Address - Street 1:1200 BISHOP ST
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-5440
Practice Address - Country:US
Practice Address - Phone:731-885-2122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4682220003Medicare NSC
TN4682220003Medicare ID - Type Unspecified