| Coahoma County School Base | |
|
1555 Lee Dr Clarksdale MS 38614-2914 | |
| (662) 624-4292 | |
| (662) 624-4354 |
| Full Name | Coahoma County School Base |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1555 Lee Dr, Clarksdale, Mississippi |
| Authorized Official Name and Position | Aurelia Jones-taylor (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6626244292 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coahoma County School Base 510 Highway 322 P O Box 1216 Clarksdale MS 38614-4717 Ph: (662) 624-4292 | Coahoma County School Base 1555 Lee Dr Clarksdale MS 38614-2914 Ph: (662) 624-4292 |
| NPI Number | 1609312891 |
|---|---|
| Provider Enumeration Date | 01/11/2017 |
| Last Update Date | 01/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609312891 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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