| Dr. Arenia C. Mallory Community Health Center, Inc. | |
|
3877 Highway 51 Goodman MS 39079-9588 | |
| (662) 468-2116 | |
| Not Available |
| Full Name | Dr. Arenia C. Mallory Community Health Center, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3877 Highway 51, Goodman, Mississippi |
| Authorized Official Name and Position | Clyde Rozell Chapman (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6628342566 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Arenia C. Mallory Community Health Center, Inc. Po Box 479 Lexington MS 39095-0479 Ph: (662) 834-1857 | Dr. Arenia C. Mallory Community Health Center, Inc. 3877 Highway 51 Goodman MS 39079-9588 Ph: (662) 468-2116 |
| NPI Number | 1104279355 |
|---|---|
| Provider Enumeration Date | 07/22/2016 |
| Last Update Date | 07/22/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104279355 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |