MEDICARE: DELTA HEALTH GROUP INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	SNF15780961	FL

General Provider Information

NPI Number	:	1386636215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELTA HEALTH GROUP INC

Provider Business Mailing Address
First Line	:	2 N PALAFOX ST
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32502-5631
Country	:	US
Telephone Number	:	850-430-0000
Fax Number	:	850-436-6766

Provider Business Practice Location Address
First Line	:	138 SANDESTIN LN
Second Line	:
City	:	DESTIN
State	:	FL
Zip	:	32550-5899
Country	:	US
Telephone Number	:	850-267-2887
Fax Number	:	850-267-3718

Authorized Official
Title or Position	:	CEO PRESIDENT
Name	:	SCOTT J BELL
Credential	:
Telephone Number	:	850-430-0000

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	12/05/2007

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