Twin States Infusion, LLC

Primary specialty

Home Infusion Therapy PharmacyTaxonomy code 3336H0001X

Legal business name

TWIN STATES INFUSION, LLC

Practice address

146 S Thomas St Ste B
Tupelo, MS 38801-5328

Phone

(662) 260-3366

Fax

(662) 269-1568

NPI assigned

Feb 7, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Logan E. Davis

Title

Owner

Phone

(205) 409-9601

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• North Mississippi Vital Care Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Druid City Infusion

  • Home Infusion Therapy Pharmacy
  • Northport, AL
  • NPI 1306277397

  Member Of

  NPD member

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586908800000",
    "number": "1154953115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 S THOMAS ST STE B",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388015328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 S THOMAS ST STE B",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388015328",
            "telephone_number": "662-260-3366",
            "fax_number": "662-269-1568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN STATES INFUSION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "LOGAN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-409-9601"
    },
    "taxonomies": [
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY PERMIT",
            "identifier": "17939",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Mississippi Vital Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Mississippi Vital Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brandon Tutor
• David Tutor
• Nathanial Tutor
• Trinity Danyella Tutor, RN
• Samuel Anton Twedt, DO
• Twin States Infusion, LLC
• Daviont'E Tyes
• Alena Bess Tyre-Littlejohn, MD
• Shelley Ann Umfress, CLPN
• Anne Marie Underwood, M.ED.

• All providers in Tupelo, MS
• Home Infusion Therapy Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.