Delta Health Center, Inc. | |
118 Front Ave Indianola MS 38751-2461 | |
(662) 741-2151 | |
(662) 741-2700 |
Full Name | Delta Health Center, Inc. |
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Speciality | Clinic/Center |
Location | 118 Front Ave, Indianola, Mississippi |
Authorized Official Name and Position | John A. Fairman (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 6627418880 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Delta Health Center, Inc. 702 Martin Luther King St Mound Bayou MS 38762-9314 Ph: (662) 741-2151 | Delta Health Center, Inc. 118 Front Ave Indianola MS 38751-2461 Ph: (662) 741-2151 |
NPI Number | 1629495452 |
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Provider Enumeration Date | 03/18/2014 |
Last Update Date | 06/12/2024 |
Medicare PECOS PAC ID | 6608783295 |
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Medicare Enrollment ID | O20140625000124 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629495452 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Delta Health Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 302 College Ave, Indianola, MS 38751 Phone: 662-884-1260 Fax: 662-741-2700 | |
Indianola Wellness Clinic, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 131 Main St, Indianola, MS 38751 Phone: 662-303-3743 | |