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Escambia County Alabama Community Hospitals, Inc.

Details

Name: Escambia County Alabama Community Hospitals, Inc.
Jurisdiction: Alabama
Legal type: Domestic Non-Profit Corporation
Status: Exists
Date of registration: 11 Apr 1995 (30 years ago) (Companies founded in April 1995)
Entity Number: 000-077-640
Register Number: 000077640
ZIP code: 36427 (Companies in Escambia, 36427)
County: Escambia
Place of Formation: Escambia County
Principal Address: BREWTON, AL
Registered Office Street Address: 1301 BELLEVILLE AVEBREWTON, AL 36427

Activities ERECT/MAINTAIN/OPERATE PUBLIC NOT-FOR-PROFIT HOSPITALS

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
LQ6DZBVL3TP7 2024-11-29 401 MEDICAL PARK DR, ATMORE, AL, 36502, 3006, USA 401 MEDICAL PARK DR, ATMORE, AL, 36502, 3006, USA

Business Information
URL www.atmorehealth.org
Division Name ATMORE COMMUNITY HOSPITAL
Congressional District 01
State/Country of Incorporation AL, USA
Activation Date 2023-12-04
Initial Registration Date 2016-01-27
Entity Start Date 1995-04-11
Fiscal Year End Close Date Sep 30

Service Classifications
NAICS Codes 622110

Points of Contacts
Electronic Business
Title PRIMARY POC
Name BRAD LOWERY
Role ADMINISTRATOR
Address 401 MEDICAL PARK DR., ATMORE, AL, 36502, 3006, USA
Title ALTERNATE POC
Name LAURA SALTER
Role PATIENT ACCOUNTING COORDINATOR
Address 401 MEDICAL PARK DR., ATMORE, AL, 36502, USA
Government Business
Title PRIMARY POC
Name BRAD LOWERY
Role ADMINISTRATOR
Address 401 MEDICAL PARK DR., ATMORE, AL, 36502, 3006, USA
Past Performance
Title PRIMARY POC
Name BRAD LOWERY
Role ADMINISTRATOR
Address 401 MEDICAL PARK DRIVE, ATMORE, AL, 36502, USA
Title ALTERNATE POC
Name LAURA SALTER
Role PATIENT ACCOUNTING COORDINATOR
Address 401 MEDICAL PARK DR., ATMORE, AL, 36502, USA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1609505916 2022-06-10 2023-01-30 PO BOX 11407 DEPT# 8332, BIRMINGHAM, AL, 352468332, US 406 MEDICAL PARK DR, ATMORE, AL, 365023016, US

Contacts
Phone +1 251-368-6245
Phone +1 251-368-6878
Fax 2513684551

Authorized person
Name KATHRYN S JOHNSON
Role DIRECTOR OF REVENUE CYCLE
Phone 2512820981

Taxonomy
Taxonomy Code 208600000X - Surgery Physician
Is Primary Yes
Taxonomy Code 208D00000X - General Practice Physician
Is Primary No

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
7KMB5 Active Non-Manufacturer 2016-03-08 2024-10-21 2029-10-21 2025-10-17

Contact Information
POC BRAD LOWERY
Phone +1 251-368-6362
Address 401 MEDICAL PARK DR, ATMORE, AL, 36502 3006, 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

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ESCAMBIA COUNTY HEALTHCARE AUTHORITY 2019 631143638 2020-07-31 ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS, INC. 578
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2019-01-01
Business code 622000
Sponsor’s telephone number 2513686348
Plan sponsor’s DBA name ATMORE COMMUNITY HOSPITAL
Plan sponsor’s mailing address 401 MEDICAL PARK DR, ATMORE, AL, 365023006
Plan sponsor’s address 401 MEDICAL PARK DR, ATMORE, AL, 365023006

Number of participants as of the end of the plan year
Active participants 578
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2020-07-31
Name of individual signing STEPHEN FISCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-31
Name of individual signing STEPHEN FISCHER
Valid signature Filed with authorized/valid electronic signature
ESCAMBIA COUNTY OF ALABAMA COMMUNITY HOSPITALS, INC. 2019 631143638 2020-07-31 ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS INC 119
File View Page
Three-digit plan number (PN) 504
Effective date of plan 2019-01-01
Business code 622000
Sponsor’s telephone number 2513686348
Plan sponsor’s DBA name ATMORE COMMUNITY HOSPITAL
Plan sponsor’s mailing address 401 MEDICAL PARK DR, ATMORE, AL, 365023006
Plan sponsor’s address 401 MEDICAL PARK DR, ATMORE, AL, 365023006

Number of participants as of the end of the plan year
Active participants 119

Signature of
Role Plan administrator
Date 2020-07-31
Name of individual signing STEPHEN FISCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-31
Name of individual signing STEPHEN FISCHER
Valid signature Filed with authorized/valid electronic signature
ATMORE COMMUNITY HOSPITAL 2019 631143638 2020-07-31 ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS INC 122
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2019-01-01
Business code 622000
Sponsor’s telephone number 2513686348
Plan sponsor’s DBA name ATMORE COMMUNITY HOSPITAL
Plan sponsor’s mailing address 401 MEDICAL PARK DR, ATMORE, AL, 365023006
Plan sponsor’s address 401 MEDICAL PARK DR, ATMORE, AL, 365023006

Number of participants as of the end of the plan year
Active participants 122

Signature of
Role Plan administrator
Date 2020-07-31
Name of individual signing STEPHEN FISCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-31
Name of individual signing STEPHEN FISCHER
Valid signature Filed with authorized/valid electronic signature
ESCAMBIA COUNTY OF ALABAMA COMMUNITY HOSPITALS, INC. 2019 631143638 2020-07-31 ESCAMBIA COUNTY ALABAMA COMMUNITY HOSPITALS INC 139
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2019-01-01
Business code 622000
Sponsor’s telephone number 2513686348
Plan sponsor’s DBA name ATMORE COMMUNITY HOSPITAL
Plan sponsor’s mailing address 401 MEDICAL PARK DR, ATMORE, AL, 365023006
Plan sponsor’s address 401 MEDICAL PARK DR, ATMORE, AL, 365023006

Number of participants as of the end of the plan year
Active participants 139

Signature of
Role Plan administrator
Date 2020-07-31
Name of individual signing STEPHEN FISCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-31
Name of individual signing STEPHEN FISCHER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
PARKER, PHILLIP L Agent

Incorporator

Name Role Address
GARRETT, BROOX G JR Incorporator 218 BELLEVILLE AVEBREWTON, AL 36426

Related by officers

PARKER, PHILLIP L

BankTrust of Brewton Mobile Diagnostics, Inc.

GARRETT, BROOX G JR

English Realty Company, Inc. Pettis Trucking Company, Inc. Brewton Area Young Men's Christian Association, Inc. Fred's of Atmore, Inc. The Woodbine Company, Inc. Juniper Ridge, Inc. BankTrust of Brewton Dunham Outfitters of North America, Inc. The Securance Group, Inc. Securance Realty, Inc.

Related by address

BREWTON, AL

Bank of Brewton Brewton Aviation Service, Inc. Brewton Flower Shop, Inc. Brewton Professional Building, Inc. Brewton Weaving Co., Incorporated Craver's Brown Service Home, Inc. Escambia County Cooperative Escambia Insurance Agency Farmers Exchange of Brewton, Inc. Fountain-Lowrey Enterprises, Inc.

Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State

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