Provider Demographics
NPI:1063907061
Name:HUMANITARIAN OUTREACH DEVELOPMENT GROUP INC
Entity type:Organization
Organization Name:HUMANITARIAN OUTREACH DEVELOPMENT GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:KINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-650-7340
Mailing Address - Street 1:4400 HICKORY HILL RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38141-6818
Mailing Address - Country:US
Mailing Address - Phone:901-650-7340
Mailing Address - Fax:901-205-0650
Practice Address - Street 1:4400 HICKORY HILL RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38141-6818
Practice Address - Country:US
Practice Address - Phone:901-650-7340
Practice Address - Fax:901-205-0650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-22
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)