| Delta Health Center, Inc | |
|
400 South Blvd Drew MS 38737-3508 | |
| (662) 745-8892 | |
| (662) 745-6228 |
| Full Name | Delta Health Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 400 South Blvd, Drew, Mississippi |
| Authorized Official Name and Position | Myrtis Small (HR-CREDENTIALING) |
| Authorized Official Contact | 6627418889 |
| 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) 745-8892 | Delta Health Center, Inc 400 South Blvd Drew MS 38737-3508 Ph: (662) 745-8892 |
| NPI Number | 1265088421 |
|---|---|
| Provider Enumeration Date | 08/14/2019 |
| Last Update Date | 07/08/2025 |
| Medicare PECOS PAC ID | 6608783295 |
|---|---|
| Medicare Enrollment ID | O20191014001158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265088421 | NPI | - | NPPES |
| 09013118 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Gough's Family And Pediatric Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 189 N Main St, Drew, MS 38737 Phone: 662-745-6638 Fax: 662-745-8480 | |
Making Moves In The Community, Incorporated Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 189 N Main St, Drew, MS 38737 Phone: 662-745-6638 |