| Name: | Cahaba Hospice, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 12 Aug 1996 (28 years ago) |
| Date of dissolution: | 13 Aug 2015 |
| Entity Number: | 000-181-531 |
| Register Number: | 000181531 |
| County: | Dallas |
| Place of Formation: | Dallas County |
| Registered Office Street Address: | 218 UNION STREETSELMA, AL 36701 |
| Registered Office Street Address ZIP Code: | 36701 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | -- |
Activities
SKILLED MEDICAL CARE/HOSPICE SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952499808 | 2006-10-10 | 2011-11-01 | 410 CHURCH ST, SELMA, AL, 367014514, US | 410 CHURCH ST, SELMA, AL, 367014514, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 334-418-0566 |
| Fax | 3344180570 |
Authorized person
| Name | MR. RICHARD WARE |
| Role | CEO/OWNER |
| Phone | 3344180566 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| License Number | 11646 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS PROVIDER NUMBER |
| Number | 011-678 |
| State | AL |
| Issuer | MEDICAID |
| Number | PIC1549E |
| State | AL |
| Name | Role |
|---|---|
| RADFORD, KIMBERLY | Incorporator |
| WARE, BARBARA | Incorporator |
| Name | Role |
|---|---|
| RADFORD, KIMBERLY | Agent |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
