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General NPI Number Information
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NPI Number | 1295822575
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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 | 10/06/2006
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Last Update Date | 10/17/2022
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Provider Practice Location Address
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Address Line | 1693 FAIRGROUNDS RD
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City | GREENVILLE
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State | MS
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Zip | 38703-7810
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Country | US
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Telephone | 662-725-1200
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Fax | 663-725-2309
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Provider Business Mailing Address
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Address Line | P.O. 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 | 662-725-1200
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Fax | 662-725-2309
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Authorized Official
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Title or Position | INTERIM CEO
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Name | MS. IRIS Y. STACKER
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Credential | RHIA
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Telephone | 662-725-2099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | 041
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License Number State | MS
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