Mallory Community Health
NPI #1053439133 in Vaiden, Mississippi
Provider Information
- NPI Number
- 1053439133
- Entity Type
- Organization
- Organization Name
- Mallory Community Health
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- Mar 27, 2007
- Last Updated
- Mar 24, 2014
Practice Location
- Address
- 201A MAGNOLIA ST
- City
- Vaiden
- State
- Mississippi
- ZIP Code
- 39176-5644
- Phone
- (662) 464-5470
Authorized Official
- Name
- MR. DEWERY MONTGOMERY
- Title
- INTERIM CEO
- Phone
- (662) 834-1857
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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