Delta Health Provider Based Clinics | |
1400 E Union St Greenville MS 38703-3246 | |
(662) 378-3783 | |
(662) 725-2289 |
Full Name | Delta Health Provider Based Clinics |
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Speciality | Clinic/Center |
Location | 1400 E Union St, Greenville, Mississippi |
Authorized Official Name and Position | Iris Y. Stacker (CEO) |
Authorized Official Contact | 6627252099 |
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 Provider Based Clinics Po Box 5247 Greenville MS 38704-5247 Ph: (662) 378-3783 | Delta Health Provider Based Clinics 1400 E Union St Greenville MS 38703-3246 Ph: (662) 378-3783 |
NPI Number | 1083764542 |
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Provider Enumeration Date | 01/10/2007 |
Last Update Date | 10/17/2022 |
Medicare PECOS PAC ID | 0042208787 |
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Medicare Enrollment ID | O20040503000961 |
Identifier | Type | State | Issuer |
---|---|---|---|
1083764542 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Maroun E Hayek |
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Provider Type | Practitioner - Hematology/oncology |
Provider Identifiers | NPI Number: 1922072891 PECOS PAC ID: 4688714496 Enrollment ID: I20091229000299 |
Provider Name | Mtanius A Sultani |
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Provider Type | Practitioner - Hematology/oncology |
Provider Identifiers | NPI Number: 1972577930 PECOS PAC ID: 3779569934 Enrollment ID: I20111213000350 |
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