Organization · Type 2 NPI

Mallory Community Health

Federally Qualified Health Center (FQHC) · Pickens, MS

NPI number 1780395632 Active

Practice location

175 Lexington Street
Pickens, MS 39146

Call (662) 834-0752 Map

Mailing address

17280 Highway 17 South
Lexington, MS 39095

Specialties and licenses

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

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

NPI record

NPI: 1780395632
Entity type: Organization (Type 2)
Issued: Dec 12, 2022
Last updated: Aug 24, 2023
Status: Active
Subpart: Yes of Mallory Community Health

Other names

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Dr. Arenia C. Mallory Community Health Center, Inc. · doing business as

Authorized official

Mrs. Latrice Hudson
Revenue Credentialing Specialist
(662) 834-0752

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 1780395632

Mallory Community Health's National Provider Identifier is 1780395632, issued on Dec 12, 2022. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Pickens, MS. The record was last updated on Aug 24, 2023.