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Contact Information

SOUTH DIXIE PHARMACY LLC
12134 SOUTH DIXIE HIGHWAY
SONORA, KY42776
 Phone: 270-949-3494
 Fax: 270-949-3494
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for SOUTH DIXIE PHARMACY LLC

NPI # 1508114463
LBN Legal business name SOUTH DIXIE PHARMACY LLC
Authorized official MATTHEW DANIELS - (CO-OWNER/PHARMACIST)
Entity Organization
Organization subpart 1 No
Enumeration date 08/27/2012
Last updated 11/12/2021 - About 5 years ago
Identifiers
KY License # P07531
KY Medicaid 7100217350
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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