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General NPI Number Information
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NPI Number | 1982595625
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Entity Type | Organization
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Legal Business Name | DELTA HEALTH CENTER, INC.
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Dates
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Enumeration Date | 07/11/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 702 MARTIN LUTHER KING ST
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City | MOUND BAYOU
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State | MS
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Zip | 38762-9314
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Country | US
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Telephone | 662-741-8800
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Fax | 662-741-2268
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Provider Business Mailing Address
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Address Line | 702 MARTIN LUTHER KING ST
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City | MOUND BAYOU
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State | MS
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Zip | 38762-9314
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Country | US
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Telephone | 662-741-8899
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Fax | 662-741-8899
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Authorized Official
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Title or Position | HR DIRECTOR
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Name | MYRTIS SMALL
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Credential |
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Telephone | 662-741-8889
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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