MEDICARE: DILLARD'S, 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1972903326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DILLARD'S, INC.

Provider Business Mailing Address
First Line	:	1600 CANTRELL RD
Second Line	:	LEGAL DEPT
City	:	LITTLE ROCK
State	:	AR
Zip	:	72201-1110
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 W MARKHAM ST
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-3198
Country	:	US
Telephone Number	:	501-661-0053
Fax Number	:

Authorized Official
Title or Position	:	GENERAL COUNSEL
Name	:	DEAN WORLEY
Credential	:
Telephone Number	:	501-376-5420

Provider Enumeration Date	:	09/03/2014
Last Update Date	:	07/07/2015

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Directions to “DILLARD'S, INC. ” Practice Location

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