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AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER INC NPI 1144227901


NPI Information

NPI: 1144227901
Provider Name: AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 25D0718770

Address:
800 OHIO AVE
CLARKSDALE, MS
ZIP 38614
Phone: (662) 624-4292
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AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC is a federally qualified health center (fqhc) clinic center in Clarksdale, MS. AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC NPI is 1144227901. The provider is registered as an organization entity type.

The provider's business location address is:

800 OHIO AVE
CLARKSDALE, MS
ZIP 38614-200
Phone: (662) 624-4292
Fax: (662) 624-4354

The provider's authorized official is Aurelia Taylor .
The authorized official title is Cheif Executive Officer and has the following contact phone number (662) 624-4292.

The CLIA number assigned to this NPI record is 25D0718770 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/7/2005 and was last updated on 1/26/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
109010039MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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