Provider Demographics
NPI:1447368600
Name:MID-DELTA HEALTH SYSTEMS INC
Entity type:Organization
Organization Name:MID-DELTA HEALTH SYSTEMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLARA
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:662-247-1254
Mailing Address - Street 1:PO BOX 373
Mailing Address - Street 2:405 NORTH HAYDEN STREET
Mailing Address - City:BELZONI
Mailing Address - State:MS
Mailing Address - Zip Code:39038-0373
Mailing Address - Country:US
Mailing Address - Phone:662-247-1254
Mailing Address - Fax:662-247-4924
Practice Address - Street 1:405 N HAYDEN ST
Practice Address - Street 2:
Practice Address - City:BELZONI
Practice Address - State:MS
Practice Address - Zip Code:39038-3639
Practice Address - Country:US
Practice Address - Phone:662-247-1254
Practice Address - Fax:662-247-4924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS25-H004Medicare ID - Type UnspecifiedMEDICARE