Delta Health Center
Organization Active NPI Federally Qualified Health Center (FQHC) · Mound Bayou, MS
NPI 1104848787 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1104848787
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Federally Qualified Health Center (FQHC) 261QF0400X
- License
- 18547 (MS)
- Legal business name
- DELTA HEALTH CENTER
- Practice address
- 702 Martin Luther King St
Mound Bayou, MS 38762-9314 - Phone
- (662) 741-2151
- Fax
- (662) 741-2339
- NPI assigned
- Jul 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Seymour Mitchell
- Title
- Ceo
- Phone
- (662) 741-2151
Corporate family (same tax ID) 33
National Provider Directory
- Tax ID family
- Women Pediatric Clinic
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | 18547 | MS | Yes |
Addresses
Primary practice location
702 Martin Luther King St
Mound Bayou, MS 38762-9314
Mailing address
702 Martin Luther King St
Mound Bayou, MS 38762-9314
Phone (662) 741-2151
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09271023 | Medicaid | MS |
Other providers in Mound Bayou, MS
- George Benford
- Waynesha E Blaylock
- Marketta Blue
- Nutusha Burns
- Community Adult Day Care
- Delta Health Center
- Delta Health Center
- Delta Health Center
- Delta Health Center
- Delta Health Center
All providers in Mound Bayou, MS · Federally Qualified Health Center (FQHC) in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.