Organization
DIVERSIFIED INFUSIONCARE SOLUTIONS, INC.
Active
Other names
Diversified InfusionCare Solution Vital Care
Organization subpart
No
Provider details
NPI number
Authorized official
STAN HAMILTON (PRESIDENT)
(662) 320-9696
Entity
Organization
Contact information
Practice address
823 HIGHWAY 12 W, SUITE E, STARKVILLE, MS 39759-3593
(662) 320-9696
(662) 320-9616
Mailing address
PO BOX 5047, MERIDIAN, MS 39302-5047
(800) 447-4095
(601) 482-7490
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
04633/02.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00330522
—
MS
05
—
00440638
—
MS
Enumeration date
07/17/2006
Last updated
08/22/2020
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