| Delta Primary Care Rural Health Clinic | |
|
110 E Baker St Suite B Indianola MS 38751-2451 | |
| (662) 887-7339 | |
| (662) 887-3920 |
| Full Name | Delta Primary Care Rural Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 110 E Baker St, Indianola, Mississippi |
| Authorized Official Name and Position | Harold James Blessitt (ADMINISTRATOR) |
| Authorized Official Contact | 6628875235 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Delta Primary Care Rural Health Clinic 110 E Baker St Indianola MS 38751-2451 Ph: (662) 887-5235 | Delta Primary Care Rural Health Clinic 110 E Baker St Suite B Indianola MS 38751-2451 Ph: (662) 887-7339 |
| NPI Number | 1821420936 |
|---|---|
| Provider Enumeration Date | 07/31/2013 |
| Last Update Date | 02/28/2020 |
| Medicare PECOS PAC ID | 6709771637 |
|---|---|
| Medicare Enrollment ID | O20130920000166 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821420936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| 282N00000X | General Acute Care Hospital | 11-102 (Mississippi) | Secondary |
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Delta Surgical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 E Baker St, Indianola, MS 38751 Phone: 662-887-7339 Fax: 662-887-3920 | |
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