Provider Demographics
NPI:1316078801
Name:DILLON MEDICAL EQUIPMENT INC
Entity type:Organization
Organization Name:DILLON MEDICAL EQUIPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:FREEMAN
Authorized Official - Last Name:CORNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:DURABLE MEDICAL EQUI
Authorized Official - Phone:270-522-7030
Mailing Address - Street 1:1173 HARDY ROAD
Mailing Address - Street 2:
Mailing Address - City:CADIZ
Mailing Address - State:KY
Mailing Address - Zip Code:42211-7689
Mailing Address - Country:US
Mailing Address - Phone:270-522-7030
Mailing Address - Fax:270-522-8072
Practice Address - Street 1:1173 HARDY ROAD
Practice Address - Street 2:
Practice Address - City:CADIZ
Practice Address - State:KY
Practice Address - Zip Code:42211-7689
Practice Address - Country:US
Practice Address - Phone:270-522-7030
Practice Address - Fax:270-522-8072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3047070OtherBLUE CROSS BLUE SHIELD
TN1452156Medicaid
TN3047070OtherBLUE CROSS BLUE SHIELD
4446780002Medicare ID - Type Unspecified