MEDICARE: DR. REUBEN R DIXON BS PHARMACY/PHARM D

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	183500000X	Pharmacist	09589	LA
2	183500000X	Pharmacist	13235	CO

General Provider Information

NPI Number	:	1336454271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REUBEN R DIXON BS PHARMACY/PHARM D

Provider Business Mailing Address
First Line	:	145 ELK PL
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2645
Country	:	US
Telephone Number	:	504-525-0918
Fax Number	:	504-525-6994

Provider Business Practice Location Address
First Line	:	145 ELK PL
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2645
Country	:	US
Telephone Number	:	504-525-0918
Fax Number	:	504-525-6994

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

Provider Enumeration Date	:	08/16/2010
Last Update Date	:	08/16/2010

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Directions to “ DR. REUBEN R DIXON BS PHARMACY/PHARM D” Practice Location

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