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NPI Code Detail

MEDICARE: DIS SOLUTIONS LLC

MEDICARE: DIS SOLUTIONS LLC
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
1332B00000XDurable Medical Equipment & Medical Supplies04633/02.1MS
2332BP3500XParenteral & Enteral Nutrition Supplies (DME)04633/021MS
33336C0004XCompounding Pharmacy
43336S0011XSpecialty Pharmacy
53336H0001XHome Infusion Therapy Pharmacy04633021MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12587143OTHEROTHER ID NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000030527OTHERMSBC BS OF MS HIT
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871770305
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIS SOLUTIONS LLC
Provider Business Mailing Address
First Line : PO BOX 2371
Second Line :
City : STARKVILLE
State : MS
Zip : 39760-2371
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 403 HOSPITAL RD
Second Line : SUITE B
City : STARKVILLE
State : MS
Zip : 39759-2164
Country : US
Telephone Number : 662-320-9696
Fax Number : 662-323-5719
Authorized Official
Title or Position : CHIEF OPER OFFICE
Name : PAUL RUSS HUDDLESTON
Credential :
Telephone Number : 662-769-0280
Provider Enumeration Date : 01/28/2008
Last Update Date : 12/15/2009

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Directions to “DIS SOLUTIONS LLC ” Practice Location

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