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Providence Hospital

Details

Name: Providence Hospital
Jurisdiction: Alabama
Legal type: Domestic Non-Profit Corporation
Status: Exists
Date of registration: 08 Feb 1858 (167 years ago)
Entity Number: 000-070-560
Register Number: 000070560
Historical Names: Trustees of the Providence Infirmary of Mobile
County: Mobile
Place of Formation: Mobile County
Registered Office Street Address: 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104
Registered Office Street Address ZIP Code: 36104
Principal Address: 6801 AIRPORT BOULEVARDMOBILE, AL 36608
Principal Address ZIP Code: 36608

Activities EXCLUSIVELY FOR CHARITABLE
RELIGIOUS
EDUCATIONAL/SCIENTIFIC

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
DRDTYBLD5CF6 2024-06-11 6801 AIRPORT BLVD, MOBILE, AL, 36608, 3709, USA PO BOX 850429, MOBILE, AL, 36608, 3709, USA

Business Information
URL http://www.providencehospital.org
Congressional District 01
State/Country of Incorporation AL, USA
Activation Date 2023-06-14
Initial Registration Date 2001-06-11
Entity Start Date 1858-02-08
Fiscal Year End Close Date Jun 30

Points of Contacts
Electronic Business
Title PRIMARY POC
Name SHAWNA SWIER
Role MGR-ACCOUNTING AND REPORTING • MWF GRANTS RESEARCH
Address 1345 PHILOMENA ST, AUSTIN, TX, 78723, 3210, USA
Government Business
Title PRIMARY POC
Name ROB MADSEN
Role DIR-ACCOUNTING AND REPORTING • MWF GRANTS RESEARCH
Address 1345 PHILOMENA ST, AUSTIN, TX, 78723, 3210, USA
Title ALTERNATE POC
Name SHAWNA SWIER
Address 1345 PHILOMENA ST, AUSTIN, TX, 78723, USA
Past Performance
Title ALTERNATE POC
Name VIPLOVE KAPOOR
Address 1345 PHILOMENA ST, AUSTIN, TX, 78723, USA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1043804628 2021-02-24 2021-02-24 1130 22ND ST S STE 1000, BIRMINGHAM, AL, 352052881, US 6701 AIRPORT BLVD BLDG B, MOBILE, AL, 366086705, US

Contacts
Phone +1 205-212-6652
Phone +1 251-266-2883

Authorized person
Name KATHLEEN HEDRICK
Role DIRECTOR NET REVENUE MANAGEMENT
Phone 2052126652

Taxonomy
Taxonomy Code 291U00000X - Clinical Medical Laboratory
Is Primary Yes

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
1GLA2 Obsolete Non-Manufacturer 1998-08-25 2024-06-11 No data 2024-06-11

Contact Information
POC ROB MADSEN
Phone +1 512-324-5615
Address 6801 AIRPORT BLVD, MOBILE, AL, 36608 3709, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

Agent

Name Role Address
CORPORATION SERVICE COMPANY INC Agent 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808

Incorporator

Name Role
CAZALE, SISTER URSULA Incorporator
THOMAS, SISTER VINCENT Incorporator
SHERLOCK, SISTER MARY ELLEN Incorporator
OBRIEN, SISTER BERNADETTE Incorporator
HARRINGTON, SISTER CLEMENT Incorporator

Director

Name Role Address
KOCH, HENRY J Director 112 LEVERT AVENUEMOBILE, AL 36607
HARRISON, CAROL M Director 144 LAKE VIEW LOOPDAPHNE, AL 36526
KENNEDY, TODD Director 6801 AIRPORT BOULEVARDMOBILE, AL 36608
GASTON, G TIMOTHY Director 3800 AIRPORT BOULEVARDMOBILE, AL 36608
HUDSON, CONNIE Director 205 GOVERNMENT STREETMOBILE, AL 36644

Events

Event Date Event Type Old Value New Value
1939-01-11 Name Change Trustees of the Providence Infirmary of Mobile Providence Hospital

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
DELIVERY ORDER AWARD 0004 2012-09-20 2012-09-28 2012-09-28
Unique Award Key CONT_AWD_0004_9700_W9127Q10A0010_9700
Awarding Agency Department of Defense
Link View Page

Award Amounts
Obligated Amount 49660.00
Current Award Amount 49660.00
Potential Award Amount 49660.00

Description
Title MEDICAL EXAM C
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q999: MEDICAL- OTHER

Recipient Details
Recipient PROVIDENCE HOSPITAL
UEI DRDTYBLD5CF6
Legacy DUNS 077900066
Recipient Address UNITED STATES, 6801 AIRPORT BLVD, MOBILE, MOBILE, ALABAMA, 366083709
DELIVERY ORDER AWARD 0003 2011-08-09 2011-08-19 2011-08-19
Unique Award Key CONT_AWD_0003_9700_W9127Q10A0010_9700
Awarding Agency Department of Defense
Link View Page

Award Amounts
Obligated Amount 93550.00
Current Award Amount 93550.00
Potential Award Amount 93550.00

Description
Title OSHA REQUIRED MEDICAL SURVEILLANCE EXAMS FOR TECHNICIANS
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q999: OTHER MEDICAL SERVICES

Recipient Details
Recipient PROVIDENCE HOSPITAL
UEI DRDTYBLD5CF6
Legacy DUNS 077900066
Recipient Address UNITED STATES, 6801 AIRPORT BLVD, MOBILE, MOBILE, ALABAMA, 366083709
DELIVERY ORDER AWARD 0002 2011-07-27 2011-09-02 2011-09-02
Unique Award Key CONT_AWD_0002_9700_W9127Q10A0010_9700
Awarding Agency Department of Defense
Link View Page

Award Amounts
Obligated Amount 47615.00
Current Award Amount 47615.00
Potential Award Amount 47615.00

Description
Title MEDICAL MONITORING AND SCREENING
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q999: OTHER MEDICAL SERVICES

Recipient Details
Recipient PROVIDENCE HOSPITAL
UEI DRDTYBLD5CF6
Legacy DUNS 077900066
Recipient Address UNITED STATES, 6801 AIRPORT BLVD, MOBILE, MOBILE, ALABAMA, 366083709
PURCHASE ORDER AWARD W9127811P0206 2011-04-21 2011-12-31 2011-12-31
Unique Award Key CONT_AWD_W9127811P0206_9700_-NONE-_-NONE-
Awarding Agency Department of Defense
Link View Page

Award Amounts
Obligated Amount 1216.00
Current Award Amount 1216.00
Potential Award Amount 1216.00

Description
Title TAS::96 4902::TAS PROVIDENCE FITNESS MEMBERSHIP FOR MOBILE DISTRICT, CORPS OF ENGINEERS, EMPLOYEES
NAICS Code 713940: FITNESS AND RECREATIONAL SPORTS CENTERS
Product and Service Codes W078: LEASE-RENT OF RECREATIONAL EQ

Recipient Details
Recipient PROVIDENCE HOSPITAL
UEI DRDTYBLD5CF6
Legacy DUNS 077900066
Recipient Address UNITED STATES, 6801 AIRPORT BLVD, MOBILE, MOBILE, ALABAMA, 366083709
PURCHASE ORDER AWARD W9127807P0182 2011-01-12 2011-01-01 2011-01-01
Unique Award Key CONT_AWD_W9127807P0182_9700_-NONE-_-NONE-
Awarding Agency Department of Defense
Link View Page

Award Amounts
Obligated Amount 1908.00
Current Award Amount 1908.00
Potential Award Amount 1908.00

Description
Title TAS::96 4902::TAS TO DEOBLIGATE AND CLOSE
NAICS Code 713940: FITNESS AND RECREATIONAL SPORTS CENTERS
Product and Service Codes Q999: OTHER MEDICAL SERVICES

Recipient Details
Recipient PROVIDENCE HOSPITAL
UEI DRDTYBLD5CF6
Legacy DUNS 077900066
Recipient Address UNITED STATES, 6801 AIRPORT BLVD, MOBILE, MOBILE, ALABAMA, 366853709
No data IDV W9127Q10A0010 2010-08-29 No data No data
Unique Award Key CONT_IDV_W9127Q10A0010_9700
Awarding Agency Department of Defense
Link View Page

Description
Title MEDICAL SURVEILLANCE
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q999: OTHER MEDICAL SERVICES

Recipient Details
Recipient PROVIDENCE HOSPITAL
UEI DRDTYBLD5CF6
Legacy DUNS 077900066
Recipient Address UNITED STATES, 6801 AIRPORT BLVD, MOBILE, 366083709
DELIVERY ORDER AWARD 0001 2010-08-29 2010-09-30 2010-09-30
Unique Award Key CONT_AWD_0001_9700_W9127Q10A0010_9700
Awarding Agency Department of Defense
Link View Page

Award Amounts
Obligated Amount 67475.00
Current Award Amount 67475.00
Potential Award Amount 67475.00

Description
Title MEDICAL SURVEILLANCE EXAM C;
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q999: OTHER MEDICAL SERVICES

Recipient Details
Recipient PROVIDENCE HOSPITAL
UEI DRDTYBLD5CF6
Legacy DUNS 077900066
Recipient Address UNITED STATES, 6801 AIRPORT BLVD, MOBILE, MOBILE, ALABAMA, 366083709
No data IDV W912JA10A0016 2010-03-01 No data No data
Unique Award Key CONT_IDV_W912JA10A0016_9700
Awarding Agency Department of Defense
Link View Page

Award Amounts
Obligated Amount 0.00
Potential Award Amount 100000.00

Description
Title MEDICAL SURVEILLANCE
NAICS Code 813920: PROFESSIONAL ORGANIZATIONS
Product and Service Codes B537: MEDICAL AND HEALTH STUDIES

Recipient Details
Recipient PROVIDENCE HOSPITAL
UEI DRDTYBLD5CF6
Recipient Address UNITED STATES, 6801 AIRPORT BLVD, MOBILE, MOBILE, ALABAMA, 366083709
PO AWARD W912JA07M0133 2008-09-18 2009-09-17 2009-09-17
Unique Award Key CONT_AWD_W912JA07M0133_9700_-NONE-_-NONE-
Awarding Agency Department of Defense
Link View Page

Description
Title MEDICAL SCREENING
NAICS Code 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product and Service Codes AN41: HEALTH SERVICES (BASIC)

Recipient Details
Recipient PROVIDENCE HOSPITAL
UEI DRDTYBLD5CF6
Legacy DUNS 077900066
Recipient Address UNITED STATES, 6801 AIRPORT BLVD, MOBILE, 366083709
PURCHASE ORDER AWARD W9127808P0219 2008-03-06 2008-12-31 2008-12-31
Unique Award Key CONT_AWD_W9127808P0219_9700_-NONE-_-NONE-
Awarding Agency Department of Defense
Link View Page

Award Amounts
Obligated Amount 3024.00
Current Award Amount 3024.00
Potential Award Amount 3024.00

Description
Title FITNESS CLUB MEMBERSHIP
NAICS Code 713940: FITNESS AND RECREATIONAL SPORTS CENTERS
Product and Service Codes Q999: OTHER MEDICAL SERVICES

Recipient Details
Recipient PROVIDENCE HOSPITAL
UEI DRDTYBLD5CF6
Legacy DUNS 077900066
Recipient Address UNITED STATES, 6801 AIRPORT BLVD, MOBILE, MOBILE, ALABAMA, 366083709

Related by officers

CORPORATION SERVICE COMPANY INC

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KENNEDY, TODD

KennedyImports&Exports L.L.C.

GASTON, G TIMOTHY

Alabama Providence Healthcare Services The Red Elephant Club of Mobile, Inc.

HUDSON, CONNIE

Mobile County P.A.L.S.

Related by address

641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104

DIVISION 7 CONSTRUCTION, INC. The Advertiser Company Alabama Farmers Cooperative, Inc. Whitfield Foods, Inc. Westfield Services, Inc. Lucia Securities, LLC Southcoast Paper Products, LLC 24 On Physicians, PC Pine Bluff Materials Co. LLC Wells Fargo Commodities, LLC

6801 AIRPORT BOULEVARDMOBILE, AL 36608

Alabama Providence Healthcare Services Gulf Coast Health System

Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State

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