Organization
MALLORY MIDNIGHT SERVICE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEROY MALLORY (PRESIDENT)
(434) 848-2066
Entity
Organization
Contact information
Practice address
306 W 6TH AVE, LAWRENCEVILLE, VA 23868-2008
(434) 848-2066
(434) 848-2119
Mailing address
306 W 6TH AVE, P O BOX 606, LAWRENCEVILLE, VA 23868-2008
(434) 848-2066
(434) 848-2119
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0251E00000X
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0153686081
API
VA
Enumeration date
11/11/2015
Last updated
11/11/2015
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