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Organization
MID-DELTA HOME HEALTH OF CHARLESTON, INC.
Active
Organization
MID-DELTA HOME HEALTH OF CHARLESTON, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CLARA T. REED RN (CEO)
(662) 247-1254
Entity
Organization
Contact information
Practice address
617 N STATE ST, CLARKSDALE, MS 38614-6517
(662) 624-4910
(662) 247-4924
Mailing address
PO BOX 373, BELZONI, MS 39038-0373
(662) 247-1254
(662) 247-4924
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
7588
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121587
—
MS
01
—
640718392A
DME
MS
05
—
70507
—
MS
01
—
70645
BLUE CROSS
MS
05
—
770387
—
MS
05
—
770448
—
MS
Enumeration date
07/12/2006
Last updated
05/08/2018
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