Organization · Type 2 NPI

Mallory Community Health

Federally Qualified Health Center (FQHC) · Goodman, MS

NPI number 1104279355 Active

Practice location

3877 Highway 51
Goodman, MS 39079-9588

Call (662) 468-2116 Map

Mailing address

PO Box 479
Lexington, MS 39095-0479

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

Other federally qualified health center (fqhc) providers in Goodman

G A Carmichael Family Health Center, Inc.Federally Qualified Health Center (FQHC) Goodman, MS NPI 1861323370

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NPI record

NPI: 1104279355
Entity type: Organization (Type 2)
Issued: Jul 22, 2016
Last updated: Jul 22, 2016
Status: Active

Other names

<unavail>
Dr. Arenia C. Mallory Community Health Center, Inc. · other name

Authorized official

Mr. Clyde Rozell Chapman, MD
Chief Executive Officer
(662) 834-2566

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104279355

Mallory Community Health's National Provider Identifier is 1104279355, issued on Jul 22, 2016. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Goodman, MS. The record was last updated on Jul 22, 2016.