Organization
DIXON MEDICAL SUPPLIES AND SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON DIXON (PRESIDENT/OWNER)
(313) 341-2100
Entity
Organization
Contact information
Practice address
16633 LIVERNOIS AVENUE, SUITE 1, DETROIT, MI 48221-3098
(313) 341-2100
(313) 341-3500
Mailing address
16633 LIVERNOIS AVE, SUITE 1, DETROIT, MI 48221-3098
(313) 341-2100
(313) 341-3500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4675791
—
MI
01
—
540H224740
BLUE CROSS BLUE SHIELD
MI
Enumeration date
07/10/2006
Last updated
04/25/2012
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