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CH040780 DELTA HEALTH CENTER, INC. (Active)
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Main Details
Name
DELTA HEALTH CENTER, INC.
Subdivision Name
DELTA HEALTH CENTER, INC.
Type
HRSA-Funded Health Center
Site ID
BPS-H80-003821
340B ID
CH040780
Grant Number
H80CS00085
Additional Details
Current Program Status
Active
Registration Date
12/1/1992
Participating Start Date
12/1/1992
Participating Approval Date
12/1/1992
Last Recertification Date
2/13/2025
Contacts
Authorizing Official
Delta Health Center Inc
John A. Fairman, CEO
(662) 741-8880
Primary Contact
Delta Health Center, Inc.
Harold Blakely, Pharmacist
(662) 741-8810
Addresses
Street Address
702 MARTIN L. KING ROAD
MOUND BAYOU, MS 38762-0900
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
April 2025
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