Delta Health Center, Inc. | |
302 College Ave Indianola MS 38751-2112 | |
(662) 884-1260 | |
(662) 741-2700 |
Full Name | Delta Health Center, Inc. |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 302 College Ave, Indianola, Mississippi |
Authorized Official Name and Position | Myrtis Small (HR/CREDENTIALING) |
Authorized Official Contact | 6627418889 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Delta Health Center, Inc. Po Box 900 Mound Bayou MS 38762-0900 Ph: (662) 884-1260 | Delta Health Center, Inc. 302 College Ave Indianola MS 38751-2112 Ph: (662) 884-1260 |
NPI Number | 1215583356 |
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Provider Enumeration Date | 08/14/2019 |
Last Update Date | 08/14/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215583356 | NPI | - | NPPES |
09013118 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Indianola Wellness Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 131 Main St, Indianola, MS 38751 Phone: 662-303-3743 | |