| Mid-delta Health Systems, Inc. | |
|
1940 S Whitehead Dr De Witt AR 72042-2906 | |
| (870) 946-4505 | |
| (870) 946-3357 |
| Full Name | Mid-delta Health Systems, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1940 S Whitehead Dr, De Witt, Arkansas |
| Authorized Official Name and Position | Rebecca Broadnax (AR/BILLING/CRED MANAGER) |
| Authorized Official Contact | 8707473381 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mid-delta Health Systems, Inc. 245 Madison St Clarendon AR 72029-2706 Ph: (870) 747-3381 | Mid-delta Health Systems, Inc. 1940 S Whitehead Dr De Witt AR 72042-2906 Ph: (870) 946-4505 |
| NPI Number | 1053938118 |
|---|---|
| Provider Enumeration Date | 07/06/2020 |
| Last Update Date | 07/06/2020 |
| Medicare PECOS PAC ID | 3870574668 |
|---|---|
| Medicare Enrollment ID | O20200807000766 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053938118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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