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Organization

MALLORY COMMUNITY HEALTH

Active
Parent organization
MALLORY COMMUNITY HEALTH
Other names
Dr. Arenia C. Mallory Community Health Center, Inc.
Organization subpart
Yes

Provider details

NPI number
Legal business name
MALLORY COMMUNITY HEALTH
Authorized official
MRS. LATRICE HUDSON (REVENUE CREDENTIALING SPECIALIST)
(662) 834-0752
Entity
Organization

Contact information

Practice address
175 LEXINGTON STREET, PICKENS, MS 39146
(662) 834-0752
Mailing address
17280 HIGHWAY 17 SOUTH, LEXINGTON, MS 39095
(662) 834-0532

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Enumeration date
12/12/2022
Last updated
08/24/2023
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