Provider Demographics
NPI:1508858259
Name:DELTA HEALTH GROUP INC
Entity Type:Organization
Organization Name:DELTA HEALTH GROUP INC
Other - Org Name:SUWANNEE HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:J
Authorized Official - Last Name:BELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-430-0000
Mailing Address - Street 1:2 N PALAFOX ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-5631
Mailing Address - Country:US
Mailing Address - Phone:850-430-0000
Mailing Address - Fax:850-436-6766
Practice Address - Street 1:1620 HELVENSTON ST SE
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:FL
Practice Address - Zip Code:32064-3474
Practice Address - Country:US
Practice Address - Phone:386-362-7860
Practice Address - Fax:386-362-4417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSNF1545096314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10-5613Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER