Provider Demographics
NPI:1841616265
Name:AARON E HENRY COMMUNITY HEALTH
Entity type:Organization
Organization Name:AARON E HENRY COMMUNITY HEALTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:AURELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES-TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-624-4292
Mailing Address - Street 1:510 HIGHWAY 322
Mailing Address - Street 2:P O BOX 1216
Mailing Address - City:CLARKSDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38614-4717
Mailing Address - Country:US
Mailing Address - Phone:662-624-2504
Mailing Address - Fax:662-624-4354
Practice Address - Street 1:643 W SERVICE DR
Practice Address - Street 2:
Practice Address - City:COLDWATER
Practice Address - State:MS
Practice Address - Zip Code:38618-3822
Practice Address - Country:US
Practice Address - Phone:662-624-4292
Practice Address - Fax:662-624-4354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-10
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)