Organization
DIS SOLUTIONS LLC
Active
Other names
DIS SOLUTIONS
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL RUSS HUDDLESTON (CHIEF OPER OFFICE)
(662) 769-0280
Entity
Organization
Contact information
Practice address
403 HOSPITAL RD, SUITE B, STARKVILLE, MS 39759-2164
(662) 320-9696
(662) 323-5719
Mailing address
PO BOX 2371, STARKVILLE, MS 39760-2371
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
04633/02.1
MS
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
04633/021
MS
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
Primary
04633021
MS
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000030527
BC BS OF MS HIT
MS
05
—
00330522
—
MS
05
—
00440638
—
MS
01
—
2587143
OTHER ID NUMBER
—
Enumeration date
01/28/2008
Last updated
12/15/2009
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