MALL SERVICES, LLC (NPI# 1285700617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285700617 |
| Entity Type | Organization |
| Organization Name | MALL SERVICES, LLC |
| Other Organization Name | CONVENIENT CARE CLINIC |
| Practice Address |
350 W Woodrow Wilson Ave Suite 615 Jackson MS 39213-7681 |
| Practice Telephone | 6019820673 |
| Practice Fax Number | 6019820459 |
| Mailing Telephone | 6019820673 |
| Mailing Fax Number | 6019820459 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CHERYL R WALKER (ADMINSTRATIVE ASSOCIATE) |
| Authorized Official Telephone | 6019820673 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
R729183 | MS | Ambulatory Health Care Facilities |
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
V-014 | MS | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 07606048 | 05 | |
| MS | 08406271 | 05 |
| Other Name | Type Code |
|---|---|
| Convenient Care Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699005983 | Mall Services, LLC | Family Medicine | 386 Raymond Rd, Building 30, Jackson, MS 39204-3700 | 2010-01-08 |
| 1568628980 | Mall Services, LLC | Clinic/Center | 2050 Martin Luther King Jr Dr, Jackson, MS 39203-1030 | 2008-08-05 |
| 1841456472 | Mall Services, LLC | Clinic/Center | 1066 Wiggins Road, Jackson, MS 39209 | 2008-08-04 |
| 1548539117 | Mall Services, LLC | Clinic/Center | 1860 Chadwick Dr, Suite 305, Jackson, MS 39204-3463 | 2011-12-27 |
| 1245477165 | Mall Services, LLC | Clinic/Center | 350 W Woodrow Wilson Ave, Suite 615, Jackson, MS 39213-7681 | 2009-01-14 |
| 1063659340 | Mall Services, LLC | Community Health Worker | 809 N State St, Jackson, MS 39202-2604 | 2009-01-08 |
| 1881878577 | Mall Services, LLC | Clinic/Center | 833 Maple St, Jackson, MS 39203-3844 | 2007-12-18 |
| Street Address |
350 W WOODROW WILSON AVE SUITE 615 |
| City | JACKSON |
| State | MS |
| Zip Code | 39213-7681 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184607210 | Srinivasan Vijayakumar | Radiology | 350 W Woodrow Wilson Ave, Suite 16, Jackson, MS 39213-7681 | 2005-11-22 |
| 1487285268 | Andreina Guedez Mijares | Dietitian, Registered | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2020-01-30 |
| 1114492725 | Kandis Vechelle Backus | Pharmacist | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2018-10-10 |
| 1780104646 | Jamie Simonson Dean | Nurse Practitioner | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2017-06-22 |
| 1730610775 | Take Care Pharmacy | Pharmacy | 350 W Woodrow Wilson Ave, Suite 311, Jackson, MS 39213-7681 | 2017-03-22 |
| 1891236725 | Christina Purviance | Nurse Practitioner | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2017-03-11 |
| 1265983316 | Molly Sullivan | Nurse Practitioner | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2016-10-24 |
| 1982057345 | Flora K. Green | Nurse Practitioner | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2016-07-20 |
| 1619346822 | Shundra Wilson | Nurse Practitioner | 350 W Woodrow Wilson Ave, Jackson, MS 39213-7681 | 2015-09-17 |
| 1336521343 | Karen Cathey | Counselor | 350 W Woodrow Wilson Ave, Suite 3572, Jackson, MS 39213-7681 | 2015-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679117980 | Cynthia Bailey | Technician | 916 Carnation Street, Jackson, MS 39213 | 2019-10-30 |
| 1871136374 | Shirley Collins Williams | Technician | 3132 Sage St, Jackson, MS 39213 | 2019-10-28 |
| 1275057069 | Nikita Patel | Pharmacist | 830 West Woodrow Wilson Avenue, Jackson, MS 39213 | 2017-08-02 |
| 1346782893 | Mississippi Smiles Dentistry LLC | Dentist | 310 W Woodrow Wilson Ave, 400, Jackson, MS 39213 | 2016-11-15 |
| 1730637521 | Ms Eyecare Associates of Jackson, Pllc. | Optometrist | 310 West Woodrow Wilson Avenue Suite 300, Jackson, MS 39213 | 2016-09-21 |
| 1518410778 | Assurance Home Health Services, LLC | Health Maintenance Organization | 1771 Hamilton Blvd., Jackson, MS 39213 | 2016-07-25 |
| 1831576180 | Dorothy Jeffries Anderson | Counselor | 350 Woodrow Wilson Ave, Jackson, MS 39213 | 2015-05-06 |
| 1740697275 | Sincere Home Care LLC. | Chore Provider | 5911 Holmes Ct, Jackson, MS 39213 | 2014-07-16 |
| 1629401088 | Deborah Diane Wright | Assisted Living Facility | 5911 Holmes Court, Jackson, MS 39213 | 2013-08-20 |
| 1245663251 | Methodist Home Road Living Center | Licensed Practical Nurse | 4560 Methodist Home Road, Jackson, MS 39213 | 2013-08-13 |
| Find all providers in zip 39213 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710545488 | Primary and Behavioral Healthcare Services, Pa | Clinic/Center | 717 E. Fortification St., Jackson, MS 39202-2402 | 2019-05-29 |
| 1366928087 | Primary Care - South Limited | Clinic/Center | 1385 South Highland Ave, Suite B-1, Jackson, TN 38301 | 2018-07-16 |
| 1114427507 | Advance Care, LLC | Clinic/Center | 14 Northtown Dr Ste 105, Jackson, MS 39211-3018 | 2018-02-13 |
| 1467841742 | Dc Medical Services Inc | Clinic/Center | 7 Stonebridge Blvd Ste C, Jackson, TN 38305-2049 | 2015-01-09 |
| 1558779728 | Rural Health Group, Inc. | Clinic/Center | 9742 Nc Highway 305, Jackson, NC 27845-9799 | 2014-07-31 |
| 1043573199 | Fondren Medical Clinic | Clinic/Center | 4436 N State St, Suite A-1, Jackson, MS 39206-5334 | 2012-06-22 |
| 1043503832 | Mid Jackson Family Health Clinic | Clinic/Center | 514c Woodrow Wilson Dr, Jackson, MS 39216 | 2011-05-26 |
| 1053646190 | More Convenient Care Center LLC | Clinic/Center | 4612 Medgar Evers Blvd, Suite 10, Jackson, MS 39213-5205 | 2009-10-07 |
| 1518121326 | University Nursing Associates Pllc | Clinic/Center | 136 W Ash St, Jackson, MS 39202-2217 | 2008-07-11 |
| 1114194347 | Community Action Committee of Pike County | Clinic/Center | 14590 St Rt 93, Family Health Center Jackson, Jackson, OH 45640 | 2008-05-16 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.