| Name: | Glenwood Healthcare, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 15 Jan 1976 (49 years ago) (Companies founded in January 1976) |
| Date of dissolution: | 08 Dec 2016 |
| Entity Number: | 000-040-150 |
| Register Number: | 000040150 |
| Historical Names: |
Glenwood Convalescent Center, Inc.
|
| ZIP code: | 35203 (Companies in Jefferson, 35203) |
| County: | Jefferson |
| Place of Formation: | Lauderdale County |
| Principal Address: | FLORENCE, AL |
| Registered Office Mailing Address: | ONE FEDERAL PLACE, 1819 FIFTH AVE NBIRMINGHAM, AL 35203-2119 |
| Registered Office Street Address: | ONE FEDERAL PLACE, 1819 FIFTH AVE NBIRMINGHAM, AL 35203 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174515704 | 2005-08-19 | 2012-01-09 | 211 ANA DRIVE, FLORENCE, AL, 356301768, US | 211 ANA DRIVE, FLORENCE, AL, 356301768, US | |||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 256-766-8963 |
| Fax | 2567682780 |
Authorized person
| Name | DR. DWIGHT M. SPEARMAN |
| Role | PRESIDENT |
| Phone | 2567668963 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 10579 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 5508 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 4751220S |
| State | AL |
| Issuer | BCBS PROVIDER NUMBER |
| Number | 010641 |
| State | AL |
| Issuer | BCBS OF ALABAMA |
| Number | 010641 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| MCKIBBEN, MICHAEL D | Agent | 3621 BIRCHWOOD LANEVESTAVIA HILLS, AL 35243 |
| Name | Role |
|---|---|
| SPEARMAN, DWIGHT | Incorporator |
| SPEARMAN, JAMES W | Incorporator |
| SPEARMAN, ELIZABETH R | Incorporator |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2008-10-10 | Name Change | Glenwood Convalescent Center, Inc. | Glenwood Healthcare, Inc. |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
