Provider Demographics
NPI:1528281557
Name:DELTA HOME CARE MED EQ & UNI INC
Entity type:Organization
Organization Name:DELTA HOME CARE MED EQ & UNI INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEROME
Authorized Official - Middle Name:MYRON
Authorized Official - Last Name:TROXLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-563-4866
Mailing Address - Street 1:313 HWY 6 WEST
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38606-2558
Mailing Address - Country:US
Mailing Address - Phone:662-563-4866
Mailing Address - Fax:662-563-4866
Practice Address - Street 1:313 HWY 6 WEST
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:MS
Practice Address - Zip Code:38606-2558
Practice Address - Country:US
Practice Address - Phone:662-563-4866
Practice Address - Fax:662-563-4866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00440221Medicaid