Delta Lifestyle Solutions
LBN: Delta Lifestyle Solutions
Delta Lifestyle Solutions is an health care organization with primary practice located at 109 Tolley Dr , Bridgeport WV 26330-1669. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Family Medicine is the primary health care specialty.
Delta Lifestyle Solutions can be contacted via phone (304) 623-6300, or through Hackney, Mary via phone (304) 623-6300.
Contact Information
Primary practice address
109 Tolley Dr
Bridgeport WV 26330-1669
Phone: (304) 623-6300
Fax: (304) 623-6302
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207QA0401X |
Profile Details
| NPI number | 1619579208 |
|---|---|
| LBN Legal business name | Delta Lifestyle Solutions |
| DBA Doing business as | |
| Authorized official | Hackney, Mary FNP-BC |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Nov 10th, 2020 |
| Last updated | Nov 5th, 2021 - about 3 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619579208 | NPPES |
| West Virginia | MEDICAID | 1639326747 |
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