Provider Demographics
NPI:1053086819
Name:DELTA HEALTH SYSTEM
Entity Type:Organization
Organization Name:DELTA HEALTH SYSTEM
Other - Org Name:DELTA HEALTH-SENATOBIA MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-278-4104
Mailing Address - Street 1:PO BOX 5247
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38704-5247
Mailing Address - Country:US
Mailing Address - Phone:601-278-4104
Mailing Address - Fax:
Practice Address - Street 1:401 GETWELL DR
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668-2213
Practice Address - Country:US
Practice Address - Phone:601-278-4104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-13
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency CareGroup - Multi-Specialty