| |
110 E Baker St Indianola MS 38751-2451 | |
(662) 887-7339 | |
(662) 887-3920 |
Full Name | |
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Speciality | Clinic/center |
Location | 110 E Baker St, Indianola, Mississippi |
Authorized Official Name and Position | Harold J. Blessitt (HOSPITAL ADMINISTRATOR) |
Authorized Official Contact | 6628875235 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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110 E Baker St Indianola MS 38751-2451 Ph: (662) 887-7339 | 110 E Baker St Indianola MS 38751-2451 Ph: (662) 887-7339 |
NPI Number | 1487685897 |
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Provider Enumeration Date | 07/05/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487685897 | NPI | - | NPPES |
09014437 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 11-102 (Mississippi) | 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 | |