Organization
TWIN STATES INFUSION, LLC
Active
Organization
TWIN STATES INFUSION, LLC
Active
Other names
North Mississippi Vital Care
Organization subpart
No
Provider details
NPI number
Authorized official
LOGAN E. DAVIS (OWNER)
(205) 409-9601
Entity
Organization
Contact information
Practice address
146 S THOMAS ST STE B, TUPELO, MS 38801-5328
(662) 260-3366
(662) 269-1568
Mailing address
146 S THOMAS ST STE B, TUPELO, MS 38801-5328
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17939
PHARMACY PERMIT
MS
Enumeration date
02/07/2020
Last updated
04/15/2020
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