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	SNF1608096	FL

General Provider Information

NPI Number	:	1710979513
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	:	602 LAURA ST
Second Line	:
City	:	STARKE
State	:	FL
Zip	:	32091-4026
Country	:	US
Telephone Number	:	904-964-3383
Fax Number	:	904-964-6621

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	:	08/22/2007

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Directions to “DELTA HEALTH GROUP INC ” Practice Location

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