MALL SERVICES, LLC (NPI# 1245477165) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245477165 |
| Entity Type | Organization |
| Organization Name | MALL SERVICES, LLC |
| Other Organization Name | CONVENIENT CARE MOBILE CLINIC |
| Practice Address |
350 W Woodrow Wilson Ave Suite 615 Jackson MS 39213-7681 |
| Practice Telephone | 6019820673 |
| Practice Fax Number | 6019820459 |
| Mailing Telephone | 6019820673 |
| Mailing Fax Number | 6019820459 |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2009-01-14 |
| Authorized Official Name | MRS. CHRISTAL ROGERS (OFFICE ASSISTANT) |
| Authorized Official Telephone | 6019820673 |
| Authorized Official Credential | LPN |
| Is Organization Subpart | Y |
| Parent Organization Name | CONVENIENT CARE CLINIC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | R656046 | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 08406271 | 05 | |
| NPI | 1710084504 | 01 | |
| MS | 00115980 | 05 |
| Other Name | Type Code |
|---|---|
| Convenient Care Mobile Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699005983 | Mall Services, LLC | Family Medicine | 386 Raymond Rd, Building 30, Jackson, MS 39204-3700 | 2010-01-08 |
| 1568628980 | Mall Services, LLC | Clinic/Center | 2050 Martin Luther King Jr Dr, Jackson, MS 39203-1030 | 2008-08-05 |
| 1841456472 | Mall Services, LLC | Clinic/Center | 1066 Wiggins Road, Jackson, MS 39209 | 2008-08-04 |
| 1548539117 | Mall Services, LLC | Clinic/Center | 1860 Chadwick Dr, Suite 305, Jackson, MS 39204-3463 | 2011-12-27 |
| 1063659340 | Mall Services, LLC | Community Health Worker | 809 N State St, Jackson, MS 39202-2604 | 2009-01-08 |
| 1881878577 | Mall Services, LLC | Clinic/Center | 833 Maple St, Jackson, MS 39203-3844 | 2007-12-18 |
| 1285700617 | Mall Services, LLC | Clinic/Center | 350 W Woodrow Wilson Ave, Suite 615, Jackson, MS 39213-7681 | 2006-11-28 |
| Street Address |
350 W WOODROW WILSON AVE SUITE 615 |
| City | JACKSON |
| State | MS |
| Zip Code | 39213-7681 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184607210 | Srinivasan Vijayakumar | Radiology | 350 W Woodrow Wilson Ave, Suite 16, Jackson, MS 39213-7681 | 2005-11-22 |
| 1487285268 | Andreina Guedez Mijares | Dietitian, Registered | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2020-01-30 |
| 1114492725 | Kandis Vechelle Backus | Pharmacist | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2018-10-10 |
| 1780104646 | Jamie Simonson Dean | Nurse Practitioner | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2017-06-22 |
| 1730610775 | Take Care Pharmacy | Pharmacy | 350 W Woodrow Wilson Ave, Suite 311, Jackson, MS 39213-7681 | 2017-03-22 |
| 1891236725 | Christina Purviance | Nurse Practitioner | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2017-03-11 |
| 1265983316 | Molly Sullivan | Nurse Practitioner | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2016-10-24 |
| 1982057345 | Flora K. Green | Nurse Practitioner | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2016-07-20 |
| 1619346822 | Shundra Wilson | Nurse Practitioner | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2015-09-17 |
| 1336521343 | Karen Cathey | Counselor | 350 W Woodrow Wilson Ave, Suite 3572, Jackson, MS 39213-7681 | 2015-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679117980 | Cynthia Bailey | Technician | 916 Carnation Street, Jackson, MS 39213 | 2019-10-30 |
| 1871136374 | Shirley Collins Williams | Technician | 3132 Sage St, Jackson, MS 39213 | 2019-10-28 |
| 1275057069 | Nikita Patel | Pharmacist | 830 West Woodrow Wilson Avenue, Jackson, MS 39213 | 2017-08-02 |
| 1346782893 | Mississippi Smiles Dentistry LLC | Dentist | 310 W Woodrow Wilson Ave, 400, Jackson, MS 39213 | 2016-11-15 |
| 1730637521 | Ms Eyecare Associates of Jackson, Pllc. | Optometrist | 310 West Woodrow Wilson Avenue Suite 300, Jackson, MS 39213 | 2016-09-21 |
| 1518410778 | Assurance Home Health Services, LLC | Health Maintenance Organization | 1771 Hamilton Blvd., Jackson, MS 39213 | 2016-07-25 |
| 1831576180 | Dorothy Jeffries Anderson | Counselor | 350 Woodrow Wilson Ave, Jackson, MS 39213 | 2015-05-06 |
| 1740697275 | Sincere Home Care LLC. | Chore Provider | 5911 Holmes Ct, Jackson, MS 39213 | 2014-07-16 |
| 1629401088 | Deborah Diane Wright | Assisted Living Facility | 5911 Holmes Court, Jackson, MS 39213 | 2013-08-20 |
| 1245663251 | Methodist Home Road Living Center | Licensed Practical Nurse | 4560 Methodist Home Road, Jackson, MS 39213 | 2013-08-13 |
| Find all providers in zip 39213 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972150084 | Wound Management Specialists, LLC | Clinic/Center | 1190 N State St Ste 2a, Jackson, MS 39202-2413 | 2019-08-22 |
| 1700449329 | Cycle 8 Health Care, LLC | Clinic/Center | 2310 Highway 80 W Ste 2260, Jackson, MS 39204-2383 | 2019-04-18 |
| 1093286544 | East Endocrine and Metabolism Pllc | Clinic/Center | 3829 Greentree Pl, Jackson, MS 39211-6737 | 2018-12-10 |
| 1760965206 | Hunter Assets Holding LLC | Clinic/Center | 1035 W Mayes St, Jackson, MS 39213-6100 | 2018-09-11 |
| 1235634759 | W A Foote Memorial Hospital Inc | Clinic/Center | 2200 Springport Rd Ste 230, Jackson, MI 49202-1432 | 2018-03-27 |
| 1336644897 | W A Foote Memorial Hospital Inc | Clinic/Center | 3305 Spring Arbor Rd Ste 500, Jackson, MI 49203-3795 | 2018-03-27 |
| 1730684580 | W. A. Foote Memorial Hospital, Inc. | Clinic/Center | 2200 Springport Rd Ste 210, Jackson, MI 49202-1432 | 2018-03-26 |
| 1164927844 | W. A. Foote Memorial Hospital, Inc. | Clinic/Center | 2200 Springport Rd Ste 800, Jackson, MI 49202-1432 | 2018-03-26 |
| 1225532120 | Robert Greer Do, LLC | Clinic/Center | 5345 Farnsworth Dr, Jackson, MS 39211-4604 | 2018-03-23 |
| 1447761713 | Celestial Health Creations | Clinic/Center | 7 Lakeland Cir Ste 300, Jackson, MS 39216-5022 | 2017-10-13 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.