Organization
DIXON MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY D WHITLEY (CEO)
(704) 982-8274
Entity
Organization
Contact information
Practice address
105 MOSS SPRINGS RD, ALBEMARLE, NC 28001-5140
(704) 982-8274
(704) 982-8280
Mailing address
105 MOSS SPRINGS RD, ALBEMARLE, NC 28001-5140
(704) 982-8274
(704) 982-8280
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
00432
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000223283
HIGHMARK BCBS PROVIDER #
NC
01
—
0432U
BCBSNC PROVIDER #
NC
05
—
7702680
—
NC
05
—
DM1002
—
SC
Enumeration date
02/01/2006
Last updated
08/22/2020
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