MALLORY COMMUNITY HEALTH


Address: 33795 Highway 12 East, Durant, MS 39063
Phone: 6626530505

MALLORY COMMUNITY HEALTH (NPI# 1902923527) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1902923527
Entity Type Organization
Organization Name MALLORY COMMUNITY HEALTH
Other Organization Name DR. ARENIA C. MALLORY COMMUNITY HEALTH CENTER, INC.
Practice Address 33795 Highway 12 East
Durant
MS 39063
Mailing Address Po Box 479
Lexington
MS 39095-0479
Practice Telephone 6626530505
Practice Fax Number 6626530466
Mailing Telephone 6628341857
Mailing Fax Number 6628344937
Enumeration Date 2007-03-26
Last Update Date 2016-07-21
Authorized Official Name MR. CLYDE ROZELL CHAPMAN II (CHEIF EXECUTIVE OFFICER)
Authorized Official Telephone 6628341857
Authorized Official Credential MD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QF0400X Clinic/Center
Specialization: Federally Qualified Health Center (FQHC)
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MS 09016221 05

Other Provider/Organization Names

Other Name Type Code
Dr. Arenia C. Mallory Community Health Center, Inc. Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1104348606 Mallory Community Health Clinic/Center 9479 Brozville Rd, Lexington, MS 39095-7090 2017-07-17
1295282358 Mallory Community Health Clinic/Center 9749 Brozville Road, Lexington, MS 39095 2016-09-07
1477009876 Mallory Community Health Clinic/Center 14494 Highway 51, Durant, MS 39063-9627 2016-08-27
1427504943 Mallory Community Health Clinic/Center 12572 Highway 12, Lexington, MS 39095-8036 2016-08-26
1104279355 Mallory Community Health Clinic/Center 3877 Highway 51, Goodman, MS 39079-9588 2016-07-22
1740624881 Mallory Community Health Clinic/Center 300 Yazoo Street, Lexington, MS 39095 2013-04-19
1053649749 Mallory Community Health Clinic/Center 201 East Washington Street, Greenwood, MS 38930 2009-11-18
1053439133 Mallory Community Health Clinic/Center 201a Magnolia St, Vaiden, MS 39176-5644 2007-03-27
1881713519 Mallory Community Health Clinic/Center 9715 Highway 12 W, Tchula, MS 39169 2007-03-27
1013034636 Mallory Community Health Clinic/Center 276 Nissan Parkway, Building C, Suite 100, Canton, MS 39046 2007-03-26

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities MALLORY COMMUNITY HEALTH CENTER 17280 Highway 17 South, Lexington, MS 39095-6614

Office Location

Street Address 33795 HIGHWAY 12 EAST
City DURANT
State MS
Zip Code 39063

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1912433459 S&m Medical Clinic Clinic/Center 403 Northwest Depot Street, Durant, MS 39063 2017-05-03
1649573833 Sharon B Lofton Nurse Practitioner 33795 Ms-12, Durant, MS 39063 2010-12-10
1922317262 James Myers Ferguson Pharmacist 33674 Hw 12, Durant, MS 39063 2010-10-05
1497073191 Durant Public School District Local Education Agency (LEA) 65 West Madison Street, Durant, MS 39063 2010-05-06
1952333999 Freds Stores of Tennessee Inc Pharmacy 33674 Highway 12, Durant, MS 39063-2602 2006-07-07
1033733951 Bonita T Roby Licensed Practical Nurse 1762 Eddisville Rd, Durant, MS 39063-2910 2020-06-05
1124100813 Durant Primary Care Clinic Clinic/Center 638 Northwest Ave, Durant, MS 39063-3337 2006-10-20
1497843676 Wirt Fletcher Shrock Jr. Family Medicine 630 Northwest Ave, Durant, MS 39063-3337 2006-10-11
1306111984 Peace Wellness Center, LLC Clinic/Center 638 Northwest Ave, Durant, MS 39063-3337 2012-03-15
1831460591 Peace Wellness Mobile Unit Early Intervention Provider Agency 638 Northwest Ave, Durant, MS 39063-3337 2012-01-25
Find all providers in zip 39063

Taxonomy Information

Taxonomy Code 261QF0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Federally Qualified Health Center (FQHC)

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1477009876 Mallory Community Health Clinic/Center 14494 Highway 51, Durant, MS 39063-9627 2016-08-27

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1871193722 Coastal Family Health Center, Inc Clinic/Center 12424 Highway 57, Vancleave, MS 39565-8608 2020-10-29
1992305445 Coastal Family Health Center, Inc Clinic/Center 5500 Hurley Wade Rd, Moss Point, MS 39562-8548 2020-10-26
1841890399 Coastal Family Health Center, Inc Clinic/Center 10700 Yellow Jacket Rd, Ocean Springs, MS 39564-8038 2020-10-26
1033755343 Access Family Health Services, Inc. Clinic/Center 179 Mullen Ave, Nettleton, MS 38858-6033 2019-11-21
1285280180 Delta Health Center, Inc Clinic/Center 506 Washington Avenue, Moorhead, MS 38761 2019-08-15
1265088421 Delta Health Center, Inc Clinic/Center 400 South Blvd, Drew, MS 38737-3508 2019-08-14
1215583356 Delta Health Center, Inc. Clinic/Center 302 College Ave, Indianola, MS 38751-2112 2019-08-14
1063068252 Delta Health Center, Inc Clinic/Center 1101 Oak St, Inverness, MS 38753-8725 2019-08-13
1750937959 Delta Health Center, Inc Clinic/Center 212 E Claiborne St, Sunflower, MS 38778-9640 2019-08-13
1750937108 Delta Health Center, Inc Clinic/Center 410 L F Packer Dr, Ruleville, MS 38771-3604 2019-08-12
Find all providers with the same taxonomy

Competitor

Search similar providers

City DURANT
Zip Code 39063

Improve Information

Please comment or provide details below to improve the information on MALLORY COMMUNITY HEALTH.

Dataset Information

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.

Trending Searches