# SUNIL MALHOTRA MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** GOOMAN MEDICAL CLINIC
- **Other names:** GOODMAN PHARMACY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1295289650
- **Legal business name:** GOOMAN MEDICAL CLINIC
- **Authorized official:** DR. SUNIL MALHOTRA MD (OWNER/PHYSICIAN)
- **Authorized official phone:** (662) 536-3331

## Contact information

- **Practice address:** 470 GOODMAN RD E, SOUTHAVEN, MS 38671-9557
- **Practice address phone:** (662) 536-3331
- **Practice address fax:** (662) 536-3329
- **Mailing address:** 470 GOODMAN RD E, SOUTHAVEN, MS 38671-9557
- **Mailing address phone:** (662) 536-3331
- **Mailing address fax:** (662) 536-3329

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/15/2016
- **Last updated:** 05/04/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 02909778 | — | MS |