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HV0413130 MONTGOMERY AIDS OUTREACH, INC. (Terminated)
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Main Details
Name
MONTGOMERY AIDS OUTREACH, INC.
Subdivision Name
Type
Ryan White Part C
340B ID
HV0413130
Grant Number
H76HA00099
Additional Details
Current Program Status
Terminated
Registration Date
10/1/1995
Participating Start Date
10/1/1995
Participating Approval Date
1/5/2004
Last Recertification Date
1/31/2022
Time Period the Assistance was Received
1/1/2022 - 12/31/2024
Termination Date
Termination Reason
4/1/2023
Failure to recertify
Contacts
Authorizing Official
West Alabama AIDS Outreach DBA Five Horizons Health Services
Billy Kirkpatrick, Chief Executive Officer
(205) 759-8470 Ext: 7
Primary Contact
West Alabama AIDS Outreach dba Five Horizons Health Services
Nicole Vazquez, 340B Program Manager
(659) 284-2371
Addresses
Street Address
2900 McGehee Road
MONTGOMERY, AL 36111
Billing Address
Montgomery AIDS Outreach, Inc.
P.O. Box 11087
Montgomery, AL 36111
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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CORRECTED ADD DATE, NEW CONTACT, 4/1/1998 - ADDR CHANGE (WAS 1209 MULBERRY STREET, MONTGOMERY, AL 36105), 7/1/1999 - ADDR CHANGE (DELETED 925 FOREST AVE. FROM ADDRESS), 7/1/2003 - ADDR CHANGE (ADDED 820 W. SOUTH BLVD TO ADDRESS)
12/27/2005
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