MEDICARE: DELTA WOUND CARE SERVICES 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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1588471205
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DELTA WOUND CARE SERVICES INC.

Provider Business Mailing Address
First Line	:	8622 HOMECOMING DR
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-8335
Country	:	US
Telephone Number	:	423-290-8765
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 W SUNFLOWER RD
Second Line	:
City	:	CLEVELAND
State	:	MS
Zip	:	38732-2507
Country	:	US
Telephone Number	:	423-290-8765
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. BARRY HELMS WHITE
Credential	:
Telephone Number	:	423-290-8765

Provider Enumeration Date	:	12/16/2024
Last Update Date	:	01/24/2025

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Directions to “DELTA WOUND CARE SERVICES INC. ” Practice Location

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