Provider Demographics
NPI:1629544291
Name:AIDS SERVICES COALITION
Entity Type:Organization
Organization Name:AIDS SERVICES COALITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:GARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-450-4286
Mailing Address - Street 1:PO BOX 169
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39403-0169
Mailing Address - Country:US
Mailing Address - Phone:601-450-4286
Mailing Address - Fax:601-450-4285
Practice Address - Street 1:121 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-3447
Practice Address - Country:US
Practice Address - Phone:601-450-4286
Practice Address - Fax:601-450-4285
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management