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MID-DELTA HOME HEALTH OF CHARLESTON INC. NPI 1457376360


NPI Information

NPI: 1457376360
Provider Name: MID-DELTA HOME HEALTH OF CHARLESTON, INC.
Classification: Home Health - 251E00000X
Entity Type: Organization

CLIA Number: 25D1047042

Address:
617 N STATE ST
CLARKSDALE, MS
ZIP 38614
Phone: (662) 624-4910
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MID-DELTA HOME HEALTH OF CHARLESTON, INC. is a home health in Clarksdale, MS. The provider is a public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. MID-DELTA HOME HEALTH OF CHARLESTON, INC. NPI is 1457376360. The provider is registered as an organization entity type.

The provider's business location address is:

617 N STATE ST
CLARKSDALE, MS
ZIP 38614-517
Phone: (662) 624-4910
Fax: (662) 247-4924

The provider's authorized official is Clara T. Reed .
The authorized official title is Ceo and has the following contact phone number (662) 247-1254.

The CLIA number assigned to this NPI record is 25D1047042 - hospice with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/12/2006 and was last updated on 5/8/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251E00000XHome Health7588MISSISSIPPIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1640718392AOTHERMISSISSIPPIDME
2770387MEDICAIDMISSISSIPPI
3121587MEDICAIDMISSISSIPPI
4770448MEDICAIDMISSISSIPPI
570645OTHERMISSISSIPPIBLUE CROSS
670507MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.