MEDICARE: MISSOURI DELTA MEDICAL CENTER

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	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215240965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MISSOURI DELTA MEDICAL CENTER

Provider Business Mailing Address
First Line	:	1008 N MAIN ST
Second Line	:
City	:	SIKESTON
State	:	MO
Zip	:	63801-5044
Country	:	US
Telephone Number	:	573-472-6016
Fax Number	:

Provider Business Practice Location Address
First Line	:	1008 N MAIN ST
Second Line	:
City	:	SIKESTON
State	:	MO
Zip	:	63801-5044
Country	:	US
Telephone Number	:	573-472-6016
Fax Number	:	573-472-7374

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MR. JASON M SCHRUMPF
Credential	:
Telephone Number	:	573-472-7601

Provider Enumeration Date	:	07/23/2010
Last Update Date	:	04/15/2026

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Directions to “MISSOURI DELTA MEDICAL CENTER ” Practice Location

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