MALL SERVICES, LLC (NPI# 1841456472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841456472 |
| Entity Type | Organization |
| Organization Name | MALL SERVICES, LLC |
| Other Organization Name | WESTSIDE COMMUNITY CLINIC |
| Practice Address |
1066 Wiggins Road Jackson MS 39209 |
| Mailing 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 | 2008-08-04 |
| Last Update Date | 2008-08-04 |
| Authorized Official Name | CHERYL R WALKER (CLINIC MANAGER) |
| Authorized Official Telephone | 6019820673 |
| Is Organization Subpart | Y |
| Parent Organization Name | JACKSON MEDICAL MALL FOUNDATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QC1500X |
Clinic/Center Specialization: Community Health |
R656046 | MS | Ambulatory Health Care Facilities |
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
V-014 | MS | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Westside Community 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 |
| 1548539117 | Mall Services, LLC | Clinic/Center | 1860 Chadwick Dr, Suite 305, Jackson, MS 39204-3463 | 2011-12-27 |
| 1245477165 | Mall Services, LLC | Clinic/Center | 350 W Woodrow Wilson Ave, Suite 615, Jackson, MS 39213-7681 | 2009-01-14 |
| 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 |
1066 WIGGINS ROAD |
| City | JACKSON |
| State | MS |
| Zip Code | 39209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235754995 | Oak Street Health Physicians Group of Mississippi, LLC | Family Medicine | 911 Ellis Ave, Jackson, MS 39209 | 2020-06-09 |
| 1760003594 | Phi Health, LLC | Ambulance | 582 Ramp Road, Suite C, Jackson, MS 39209 | 2020-05-04 |
| 1720468911 | Genoa Healthcare, LLC | Pharmacy | 3450 Highway 80 W Rm 68, Jackson, MS 39209 | 2015-06-03 |
| 1013302082 | Tiffany Griffin | Nurse Practitioner | 3450 Highway 80 West, Jackson, MS 39209 | 2015-04-06 |
| 1679961957 | Cassetta Shontae Mcgee | Emergency Medical Technician, Basic | 5326 Queen Eleanor Ln, Jackson, MS 39209 | 2015-01-08 |
| 1124381280 | Martin Solution | In Home Supportive Care | 917 West Ridge, Jackson, MS 39209 | 2012-06-22 |
| 1649533589 | Adrinnie M Martin | Contractor | 917 Westridge, Jackson, MS 39209 | 2012-06-15 |
| 1831423862 | Infinity House, Inc | In Home Supportive Care | 1042 Pecan Park Circle, Jackson, MS 39209 | 2009-09-23 |
| 1174751093 | Linda M Vance | Nurse Practitioner | 1000 Metrocenter Ste 105, Jackson, MS 39209 | 2009-06-30 |
| 1770729998 | Kim Hestle | Speech-Language Pathologist | 733 N. Flag Chapel Road, Jackson, MS 39209 | 2008-12-17 |
| Find all providers in zip 39209 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
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|---|---|---|---|---|
| 1033455852 | Global Treatment Clinic of Jackson LLC | Clinic/Center | 2460 Terry Rd, Suite 800, Jackson, MS 39204-5767 | 2012-12-26 |
| 1164652962 | The Steets Corporation | Clinic/Center | 3566 N Highland Ave, Suite A, Jackson, TN 38305-7890 | 2009-07-15 |
| 1568628980 | Mall Services, LLC | Clinic/Center | 2050 Martin Luther King Jr Dr, Jackson, MS 39203-1030 | 2008-08-05 |
| 1295727287 | Mact Health Board, Inc. | Clinic/Center | 12140/12150 New York Ranch Rd, Jackson, CA 95642-9407 | 2005-08-17 |
| 1396929907 | Neighborhood Medical Services, LLC | Clinic/Center | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2007-12-19 |
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| 1740310549 | Julia Street Clinic, Inc. | Clinic/Center | 102 Julia Street, Isola, MS 38754 | 2007-03-07 |
| 1932219524 | Access Family Health Services, Inc. | Clinic/Center | 60024 Olive St, Smithville, MS 38870-9719 | 2006-08-30 |
| 1730299827 | Access Family Health Services, Inc. | Clinic/Center | 12725 Highway 23 North, Tremont, MS 38876 | 2006-08-30 |
| 1033107289 | Coastal Family Health Center Inc | Clinic/Center | 15024 Martin Luther King Jr Blvd, Gulfport, MS 39501-8306 | 2005-10-12 |
| 1821092552 | North Mississippi Primary Health Care, Inc. | Clinic/Center | 15921 Boundary Dr, Ashland, MS 38603-7740 | 2005-06-10 |
| 1588106553 | 121 Medical Place, Inc | Clinic/Center | 820 Mangum Ave, Mendenhall, MS 39114-3025 | 2016-11-08 |
| 1154878106 | Trina Health of Booneville, Inc. | Clinic/Center | 202 N 1st St Ste B, Booneville, MS 38829-2718 | 2016-09-07 |
| Find all providers with the same taxonomy | ||||
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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.