Medical Mall Health Services At Cmmc

LBN: Mall Services, Llc
Medical Mall Health Services At Cmmc is an health care organization with primary practice located at 1860 Chadwick Dr Suite 305, Jackson MS 39204-3463. The organization recently has only one registered license in Ambulatory Health Care Facilities / Health Service, which is considered as the primary health care specialty. Mall Services, Llc can be contacted via phone (601) 503-4960, or through Shirley, Aaron via phone (601) 982-0673.

Contact Information

Primary practice address
1860 Chadwick Dr Suite 305 Jackson MS 39204-3463
Fax: (601) 982-0459
Website:
Authorized official contact:
Name: Shirley, Aaron Doctor of Medicine (MD)

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Health Service 261QH0100X 10119 Mississippi

Profile Details

NPI number 1548539117
LBN Legal business name Mall Services, Llc
DBA Doing business as Medical Mall Health Services At Cmmc
Authorized official Shirley, Aaron Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 27th, 2011
Last updated Dec 27th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548539117 NPPES
Mississippi MEDICAID 08406271

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