| Delta Health Center, Inc. | |
|
2363 Highway 1 S Greenville MS 38701-8337 | |
| (662) 334-1253 | |
| (662) 332-0443 |
| Full Name | Delta Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2363 Highway 1 S, Greenville, 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 |
|---|---|
| Delta Health Center, Inc. 702 Martin Luther King St Mound Bayou MS 38762-9314 Ph: (662) 741-8800 | Delta Health Center, Inc. 2363 Highway 1 S Greenville MS 38701-8337 Ph: (662) 334-1253 |
| NPI Number | 1215358783 |
|---|---|
| Provider Enumeration Date | 12/30/2013 |
| Last Update Date | 06/22/2016 |
| Medicare PECOS PAC ID | 6608783295 |
|---|---|
| Medicare Enrollment ID | O20140207001450 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215358783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Mississippi) | Primary |
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