Dr. Arenia C. Mallory Community Health Center, Inc. is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Tchula, Mississippi. The current practice location for Dr. Arenia C. Mallory Community Health Center, Inc. is 9715 Highway 12 W, Tchula, Mississippi. For appointments, you can reach them via phone at
(662) 235-4731. The mailing address for Dr. Arenia C. Mallory Community Health Center, Inc. is Po Box 479, Lexington, Mississippi and phone number is (662) 834-1857.
Dr. Arenia C. Mallory Community Health Center, Inc. is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1881713519. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(662) 235-4731.
Primary Care Clinic Profile
| Full Name | Dr. Arenia C. Mallory Community Health Center, Inc. |
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| Speciality | Clinic/Center |
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| Location | 9715 Highway 12 W, Tchula, Mississippi |
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| Authorized Official Name and Position | Clyde Rozell Chapman (CHIEF EXECUTIVE OFFICER) |
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| Authorized Official Contact | 6628341857 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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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.
9715 Highway 12 W
Tchula
MS 39169
Ph: (662) 235-4731 |
NPI Details:
| NPI Number | 1881713519 |
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| Provider Enumeration Date | 03/27/2007 |
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| Last Update Date | 07/21/2016 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 9739074501 |
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| Medicare Enrollment ID | O20101123000418 |
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Medical Identifiers
Medical identifiers for Dr. Arenia C. Mallory Community Health Center, Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1881713519 | NPI | - | NPPES |
| 09015634 | Medicaid | MS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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