# MALLORY MIDNIGHT SERVICE CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1871966945
- **Authorized official:** MR. LEROY MALLORY (PRESIDENT)
- **Authorized official phone:** (434) 848-2066

## Contact information

- **Practice address:** 306 W 6TH AVE, LAWRENCEVILLE, VA 23868-2008
- **Practice address phone:** (434) 848-2066
- **Practice address fax:** (434) 848-2119
- **Mailing address:** 306 W 6TH AVE, P O BOX 606, LAWRENCEVILLE, VA 23868-2008
- **Mailing address phone:** (434) 848-2066
- **Mailing address fax:** (434) 848-2119

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 0251E00000X | VA | Yes |

## Other

- **Enumeration date:** 11/11/2015
- **Last updated:** 11/11/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0153686081 | API | VA |