| Delta Health Center, Inc | |
|
14000 Highway 82 W Itta Bena MS 38941-1400 | |
| (662) 741-8800 | |
| Not Available |
| Full Name | Delta Health Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 14000 Highway 82 W, Itta Bena, Mississippi |
| Authorized Official Name and Position | Hazel D Whiting (CFO) |
| Authorized Official Contact | 6627418871 |
| 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 14000 Highway 82 W Itta Bena MS 38941-1400 Ph: (662) 741-8800 |
| NPI Number | 1235802695 |
|---|---|
| Provider Enumeration Date | 07/30/2021 |
| Last Update Date | 07/08/2025 |
| Medicare PECOS PAC ID | 6608783295 |
|---|---|
| Medicare Enrollment ID | O20211115000210 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235802695 | NPI | - | NPPES |
| 09013118 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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