Provider Demographics
NPI:1306141361
Name:DIXIE HOSPICE CARE, LLC
Entity type:Organization
Organization Name:DIXIE HOSPICE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:SORENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-669-4510
Mailing Address - Street 1:352 E RIVERSIDE DR STE B3B
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-5808
Mailing Address - Country:US
Mailing Address - Phone:435-628-8347
Mailing Address - Fax:435-628-3472
Practice Address - Street 1:352 E RIVERSIDE DR STE B3B
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-5808
Practice Address - Country:US
Practice Address - Phone:435-628-8347
Practice Address - Fax:435-628-3472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-21
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based