Provider Demographics
NPI:1336823228
Name:DELTA HEALTH CENTER, INC
Entity Type:Organization
Organization Name:DELTA HEALTH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:HAZEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:WHITING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-741-8871
Mailing Address - Street 1:PO BOX 900
Mailing Address - Street 2:
Mailing Address - City:MOUND BAYOU
Mailing Address - State:MS
Mailing Address - Zip Code:38762-0900
Mailing Address - Country:US
Mailing Address - Phone:662-741-8810
Mailing Address - Fax:662-741-8897
Practice Address - Street 1:118 FRONT AVE
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751-2461
Practice Address - Country:US
Practice Address - Phone:662-741-8810
Practice Address - Fax:662-741-8897
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DELTA HEALTH CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy