JERRY C MALLORY JR.


Address: 4018 Bayard 44121, Apo, AA 44121
Phone: 2165330094

JERRY C MALLORY JR. (NPI# 1447702154) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1447702154
Entity Type Individual
Full Name JERRY C MALLORY JR.
Practice Address 4018 Bayard 44121
Apo
AA 44121
Mailing Address 4018 Bayard
4018 Bayard
Cleveland
OH 44121
Practice Telephone 2165330094
Mailing Telephone 2165330094
Enumeration Date 2016-10-28
Last Update Date 2016-10-28
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 171000000X Military Health Care Provider OH Other Service Providers

Office Location

Street Address 4018 BAYARD 44121
City APO
State AA
Zip Code 44121

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1679018725 Safe Haven Residential Services In Home Supportive Care 2515 Belvoir Rd, Cleveland, OH 44121 2016-12-28
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Taxonomy Information

Taxonomy Code 171000000X
Grouping Other Service Providers
Classification Military Health Care Provider

Taxonomy Definition

Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
Notes: [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1730700253 Udaya Dahal Military Health Care Provider Grafenwoehr, De Tower Barracks, Usag-b, Apo, AE 09114 2020-05-06
1386273449 Nicholas Thomas Nelson Military Health Care Provider 633d Medical Group, 76 Nealy Ave, Building #92, Apo, AA 23665 2020-04-02
1538795679 Tanner Sean Harvey Military Health Care Provider 1mrb Bas, Apo, AA 92010 2020-03-20
1124686472 Oscar Christian Military Health Care Provider Hospital: Wh3s9a 549 Hc/baach, Unit 15245, Apo, AP 96271 2019-06-02
1932687340 Jennifer Marie Sisson Military Health Care Provider 4-2 Arb, Apo, AP 96271 2018-07-30
1962921049 Heidi Grondahl Military Health Care Provider Building 2, Del Din Clinic, Apo, AE 09606 2017-09-11
1922546654 Alexandria Fraleigh Jaksha Military Health Care Provider Blg 8740 Unit 23809, Cmr 405, Bx 52, Apo, AE 09034 2017-02-01
1306226121 Clinton Rebello Military Health Care Provider Mcguire Afb, Apo, AA 08610 2015-06-06
1255661005 Thomas J Drummond Military Health Care Provider Hhc 3-4 Inf, Cmr 405 Box #5427, Apo, AE 09034 2009-12-29
1194851261 Rodolfo Lim Cubacub Military Health Care Provider Cmr 457, Box 639, Apo, AE 09033 2007-02-26
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Competitor

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City APO
Zip Code 44121

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Dataset Information

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.

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