| Delta Health Center, Inc. | |
|
1414 Hospital St Greenville MS 38703-3217 | |
| (662) 335-3991 | |
| (662) 332-1736 |
| Full Name | Delta Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1414 Hospital St, Greenville, Mississippi |
| Authorized Official Name and Position | John Fairman (CEO) |
| Authorized Official Contact | 6627412358 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Delta Health Center, Inc. 702 Martin Luther King Road Post Office Box 900 Mound Bayou MS 38762-0900 Ph: (662) 335-3991 | Delta Health Center, Inc. 1414 Hospital St Greenville MS 38703-3217 Ph: (662) 335-3991 |
| NPI Number | 1508057076 |
|---|---|
| Provider Enumeration Date | 08/08/2007 |
| Last Update Date | 11/23/2010 |
| Medicare PECOS PAC ID | 6608783295 |
|---|---|
| Medicare Enrollment ID | O20030129000019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508057076 | NPI | - | NPPES |
| 09014251 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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