Provider Demographics
NPI:1699316471
Name:MONTGOMERY AIDS OUTREACH, INC.
Entity type:Organization
Organization Name:MONTGOMERY AIDS OUTREACH, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN-REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-386-0853
Mailing Address - Street 1:PO BOX 11087
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36111-0087
Mailing Address - Country:US
Mailing Address - Phone:334-280-3349
Mailing Address - Fax:334-356-1426
Practice Address - Street 1:3052 MCGEHEE RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36111-2203
Practice Address - Country:US
Practice Address - Phone:334-239-9704
Practice Address - Fax:334-356-1426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-03
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental