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CH04798G DR. ARENIA C. MALLORY COMMUNITY HEALTH CENTER, INC. (Active)
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Main Details
Name
DR. ARENIA C. MALLORY COMMUNITY HEALTH CENTER, INC.
Subdivision Name
Mallory Mobile RV Clinic
Type
HRSA-Funded Health Center
Site ID
BPS-H80-030597
340B ID
CH04798G
Grant Number
H80CS00580
Additional Details
Current Program Status
Active
Registration Date
4/17/2023
Participating Start Date
7/1/2023
Participating Approval Date
4/19/2023
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
Mallory Community Health Center
Clyde Rozell Chapman, CEO
(662) 834-2566 Ext: 1013
Primary Contact
Mallory Community Health Center
Sammie Binder, Risk and Safety Officer
(662) 834-1857 Ext: 1030
Addresses
Street Address
17280 Highway 17
Lexington, MS 39095-6614
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
April 2025
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