MEDICARE: DICKSON MEDICAL EQUIPMENT, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BX2000X	Oxygen Equipment & Supplies (DME)	0000000710	TN

General Provider Information

NPI Number	:	1225203847
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DICKSON MEDICAL EQUIPMENT, INC.

Provider Business Mailing Address
First Line	:	760 HWY 46 S
Second Line	:
City	:	DICKSON
State	:	TN
Zip	:	37055-2556
Country	:	US
Telephone Number	:	615-446-7444
Fax Number	:	615-446-7483

Provider Business Practice Location Address
First Line	:	117 N CONALCO DR
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38301-3663
Country	:	US
Telephone Number	:	731-660-5080
Fax Number	:	731-660-0025

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ERIC JASON SHIFLET
Credential	:
Telephone Number	:	615-446-7444

Provider Enumeration Date	:	04/24/2008
Last Update Date	:	02/14/2011

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