Organization
MALLORY COMMUNITY HEALTH
Active
Other names
DR ARENIA C MALLORY COMMUNITY HEALTH CENTER, INC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEWERY MONTGOMERY (INTERIM CEO)
(662) 834-1857
Entity
Organization
Contact information
Practice address
201A MAGNOLIA ST, VAIDEN, MS 39176-5644
(662) 464-5470
(662) 464-0152
Mailing address
PO BOX 369, VAIDEN, MS 39176-0369
(662) 464-5470
(662) 464-0152
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
03/27/2007
Last updated
03/24/2014
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