| Dr. Arenia C. Mallory Community Health Center, Inc. | |
|
201 East Washington Street Greenwood MS 38930 | |
| (662) 453-4522 | |
| (662) 453-4518 |
| Full Name | Dr. Arenia C. Mallory Community Health Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 201 East Washington Street, Greenwood, Mississippi |
| Authorized Official Name and Position | Clyde Rozell Chapman (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6628341857 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Arenia C. Mallory Community Health Center, Inc. Po Box 479 Lexington MS 39095-0479 Ph: (662) 834-1857 | Dr. Arenia C. Mallory Community Health Center, Inc. 201 East Washington Street Greenwood MS 38930 Ph: (662) 453-4522 |
| NPI Number | 1053649749 |
|---|---|
| Provider Enumeration Date | 11/18/2009 |
| Last Update Date | 10/21/2016 |
| Medicare PECOS PAC ID | 9739074501 |
|---|---|
| Medicare Enrollment ID | O20140915001755 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053649749 | NPI | - | NPPES |
| 03357572 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Gorton Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1401 River Rd, Attn Clinic Administration, Greenwood, MS 38930 Phone: 662-459-7189 Fax: 662-459-1147 | |
Leflore Specialty Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1401 River Rd, Greenwood, MS 38930 Phone: 662-451-7881 | |
Greenwood Comprehensive Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 517 Highway 82 W, Greenwood, MS 38930 Phone: 662-455-6767 Fax: 662-455-1774 | |
Michael T. Boler, M.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 Walthall St, Greenwood, MS 38930 Phone: 662-453-5331 Fax: 662-453-5332 | |
State Of Mississippi - University Of Mississippi Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 9th St, Greenwood, MS 38930 Phone: 662-227-7000 | |
Dr Charles L Nause Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 110 E Market St, Greenwood, MS 38930 Phone: 662-453-5460 Fax: 662-453-5551 |