| Delta Health System | |
|
300 S Washington Ave Greenville MS 38701-4719 | |
| (662) 344-9100 | |
| (662) 725-1154 |
| Full Name | Delta Health System |
|---|---|
| Speciality | Clinic/Center |
| Location | 300 S Washington Ave, Greenville, Mississippi |
| Authorized Official Name and Position | Iris Y. Stacker (INTERIM CEO) |
| Authorized Official Contact | 6627252099 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Delta Health System Po Box 4739 Greenville MS 38704-4739 Ph: (662) 725-2423 | Delta Health System 300 S Washington Ave Greenville MS 38701-4719 Ph: (662) 344-9100 |
| NPI Number | 1366592610 |
|---|---|
| Provider Enumeration Date | 01/11/2007 |
| Last Update Date | 10/17/2022 |
| Medicare PECOS PAC ID | 0042208787 |
|---|---|
| Medicare Enrollment ID | O20050419000915 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366592610 | NPI | - | NPPES |
| 09015375 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
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