MEDICARE: DR. PACHIA DIXON PHARM.D.,AAHIVP,MPH

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	PS46020	FL
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	PU8017	FL
3	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	RPH029588	GA

General Provider Information

NPI Number	:	1801337621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PACHIA DIXON PHARM.D.,AAHIVP,MPH

Provider Business Mailing Address
First Line	:	PO BOX 7222
Second Line	:
City	:	GARDEN CITY
State	:	GA
Zip	:	31418-7222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	PO BOX 7222
Second Line	:
City	:	GARDEN CITY
State	:	GA
Zip	:	31418-7222
Country	:	US
Telephone Number	:	912-480-7530
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/13/2017
Last Update Date	:	05/02/2019

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