Provider Demographics
NPI:1023584687
Name:MOBILE INFIRMARY ASSOCIATION
Entity type:Organization
Organization Name:MOBILE INFIRMARY ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-435-5037
Mailing Address - Street 1:169 MOBILE INFIRMARY BLVD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-3509
Mailing Address - Country:US
Mailing Address - Phone:251-435-6950
Mailing Address - Fax:251-435-6940
Practice Address - Street 1:169 MOBILE INFIRMARY BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3509
Practice Address - Country:US
Practice Address - Phone:251-435-6950
Practice Address - Fax:251-435-6940
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOBILE INFIRMARY ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)