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General NPI Number Information
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NPI Number | 1053086819
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Entity Type | Organization
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Legal Business Name | DELTA HEALTH SYSTEM
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Dates
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Enumeration Date | 08/13/2021
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Last Update Date | 11/14/2022
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Provider Practice Location Address
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Address Line | 401 GETWELL DR
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City | SENATOBIA
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State | MS
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Zip | 38668-2213
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Country | US
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Telephone | 601-278-4104
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5247
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City | GREENVILLE
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State | MS
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Zip | 38704-5247
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Country | US
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Telephone | 601-278-4104
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Fax |
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Authorized Official
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Title or Position | CAO
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Name | JOSHUA HAMMONS
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Credential |
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Telephone | 601-278-4104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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