Organization
AARON E. HENRY COMMUNITY HEALTH
Active
Parent organization
AARON E. HENRY COMMUNITY HEALTH
Other names
Aurelia Jones - Taylor Administrative Complex
Organization subpart
Yes
Provider details
NPI number
Legal business name
AARON E. HENRY COMMUNITY HEALTH
Authorized official
CANDACE L FONDREN (REVENUE CYCLE MANAGER)
(662) 624-4292
Entity
Organization
Contact information
Practice address
600 OHIO AVE, CLARKSDALE, MS 38614-6020
(662) 624-4292
(662) 351-3303
Mailing address
PO BOX 1216, CLARKSDALE, MS 38614-1216
(662) 624-4292
(662) 351-3303
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09010039
—
MS
Enumeration date
03/11/2022
Last updated
08/19/2022
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