Dixie Pharmacy-4 LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

DIXIE PHARMACY-4 LLC

Doing business as

Dixie Pharmacy-4

Practice address

124 N Main St
Smiths Grove, KY 42171-8323

Phone

(615) 525-3142

NPI assigned

Jan 18, 2019

Last updated

Jan 18, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Navas Yoonus

Title

Ceo

Phone

(615) 525-3142

Specialties & licenses 2

Addresses

Other names 1

• DIXIE PHARMACY-4 Doing business as

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1547769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547769600000",
    "number": "1962976373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 N MAIN ST",
            "city": "SMITHS GROVE",
            "state": "KY",
            "postal_code": "421718323",
            "telephone_number": "615-525-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 N MAIN ST",
            "city": "SMITHS GROVE",
            "state": "KY",
            "postal_code": "421718323",
            "telephone_number": "615-525-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIXIE PHARMACY-4 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-18",
        "last_updated": "2019-01-18",
        "status": "A",
        "authorized_official_last_name": "YOONUS",
        "authorized_official_first_name": "NAVAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-525-3142",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DIXIE PHARMACY-4",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Jessica Hampton, APRN
• Morgan Brittney Hodowanic
• Paul Isenberg
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• Erin Jenson, PT

• Community/Retail Pharmacy in Smiths Grove, KY
• Providers in Smiths Grove, KY by specialty
• Community/Retail Pharmacy in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.