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General NPI Number Information
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NPI Number | 1134868672
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Entity Type | Organization
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Legal Business Name | AARON E. HENRY COMMUNITY HEALTH SERVICES CENTER, INC
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 2245 N STATE ST
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City | CLARKSDALE
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State | MS
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Zip | 38614-6102
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Country | US
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Telephone | 662-624-4292
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Fax | 662-624-4354
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Provider Business Mailing Address
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Address Line | PO BOX 1216
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City | CLARKSDALE
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State | MS
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Zip | 38614-1216
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Country | US
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Telephone | 662-624-4292
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Fax | 662-624-4354
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGER
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Name | CANDACE L FONDREN
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Credential |
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Telephone | 662-624-4292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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