| Name: | HealthMark Home Medical Equipment, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 30 May 1997 (27 years ago) (Companies founded in May 1997) |
| Entity Number: | 000-188-067 |
| Register Number: | 000188067 |
| ZIP code: | 36701 (Companies in Dallas, 36701) |
| County: | Dallas |
| Place of Formation: | Montgomery County |
| Registered Office Street Address: | 425 SOUTH PERRY STREETMONTGOMERY, AL 36104 |
| Principal Address: | 1523 COUNTY ROAD 230SELMA, AL 36701 |
| Authorized Capital: | $10 |
Activities
ANY LAWFUL BUSINESS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851308845 | 2006-08-02 | 2013-07-24 | PO BOX 853, SELMA, AL, 367020853, US | 2918 CITIZENS PKWY, SELMA, AL, 36701, US | |||||||||||||||||||||
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| Phone | +1 334-418-0085 |
| Fax | 3344184719 |
Authorized person
| Name | MRS. LISA JONES SURRETT |
| Role | ADMINISTRATIVE TECH |
| Phone | 3344180085 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009710160 |
| State | AL |
| CAGE number | Status | Type | Established | CAGE Update Date | CAGE Expiration | SAM Expiration | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 6QKM9 | Active | Non-Manufacturer | 2012-04-25 | 2022-03-11 | 2026-03-12 | 2022-03-11 | |||||||||||||||
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| POC | MARK A. STORY |
| Phone | +1 334-431-0102 |
| Fax | +1 334-418-4719 |
| Address | 2918 CITIZENS PKWY, SELMA, AL, 36701 3947, 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 |
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| Name | Role |
|---|---|
| STORY, MARK ALLEN | Agent |
| Name | Role |
|---|---|
| STORY, MARK ALLEN | Incorporator |
| STORY, REGINA LEE | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
