Delta Health System

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

DELTA HEALTH SYSTEM

Practice address

785 Ohio Ave Ste 1H
Clarksdale, MS 38614-6213

Phone

(662) 624-8400

NPI assigned

Aug 3, 2021

Organization subpart

Yes

Parent organization

DELTA HEALTH SYSTEMAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Iris Stacker

Title

Ceo

Phone

(662) 725-2020

Specialties & licenses 1

Addresses

Other names 1

• Delta Health-Northwest Regional (RHC) Doing business as

Tax ID family

Delta Health System2 organizations share this tax ID, including this one

Part of

Delta Regional Medical Center Ambulance Service

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Delta Health System

  • Community/Retail Pharmacy
  • Clarksdale, MS
  • NPI 1275109027
  NPD tax ID

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Delta Health System

  • Oncology Clinic/Center
  • Clarksdale, MS
  • NPI 1578171872

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1831863950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4597",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387044597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 OHIO AVE STE 1H",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386146213",
            "telephone_number": "662-624-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA HEALTH SYSTEM",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DELTA HEALTH SYSTEM",
        "enumeration_date": "2021-08-03",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "STACKER",
        "authorized_official_first_name": "IRIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-725-2020"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delta Health-Northwest Regional (RHC)",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Delta Health-Northwest Regional (RHC)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Delta Health System
• Delta Health System
• Delta Health System
• Delta Health System
• Delta Health System
• Delta Medical Foundation
• Delta Medical Foundation
• Delta Neurology Clinic, PLLC
• Delta Radiology Associates, PLLC
• Joseph Aaron Dikun, PHARM.D.

• Rural Health Clinic/Center in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• Rural Health Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.