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LifeCare of Alabama, Inc.

Details

Name: LifeCare of Alabama, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 29 Oct 1999 (25 years ago) (Companies founded in October 1999)
Entity Number: 000-206-046
Register Number: 000206046
ZIP code: 35640 (Companies in Morgan, 35640)
County: Morgan
Place of Formation: Morgan County
Principal Address: HARTSELLE, AL
Registered Office Street Address: 205 HOLLOWAY ST NWHARTSELLE, AL 35640
Authorized Capital: 10,000 NPV

Activities PROVIDE AMBULANCE SERVICE

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
VD5JUU9LRJG3 2024-11-07 532A SPARKMAN ST SW, HARTSELLE, AL, 35640, 3120, USA P O BOX 1105, HARTSELLE, AL, 35640, 1105, USA

Business Information
Congressional District 05
State/Country of Incorporation AL, USA
Activation Date 2023-11-10
Initial Registration Date 2004-10-07
Entity Start Date 1999-12-01
Fiscal Year End Close Date Sep 30

Service Classifications
NAICS Codes 485991, 485999, 488999, 621910

Points of Contacts
Electronic Business
Title PRIMARY POC
Name CHARLES BUMPUS
Role PRESIDENT
Address P O BOX 1105, HARTSELLE, AL, 35640, 1105, USA
Title ALTERNATE POC
Name SUSAN CLINGMAN BANKS
Address P O BOX 1105, HARTSELLE, AL, 35640, 1105, USA
Government Business
Title PRIMARY POC
Name CHARLES BUMPUS
Role PRESIDENT
Address P O BOX 1105, HARTSELLE, AL, 35640, 1105, USA
Title ALTERNATE POC
Name SUSAN CLINGMAN BANKS
Address P O BOX 1105, HARTSELLE, AL, 35640, 1105, USA
Past Performance Information not Available

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1760595896 2006-08-15 2008-04-20 PO BOX 1105, HARTSELLE, AL, 356401105, US 532 SPARKMAN ST SW, HARTSELLE, AL, 356403120, US

Contacts
Phone +1 256-773-6035
Fax 2567514855
Fax 2567514805

Authorized person
Name SUSAN CLINGMAN BANKS
Role DIRECTOR
Phone 2567736035

Taxonomy
Taxonomy Code 3416L0300X - Land Ambulance
License Number 806
State AL
Is Primary Yes

Other Provider Identifiers
Issuer BLUE CROSS BLUE SHIELD
Number 515-51761
State AL
Issuer BLUE CROSS BLUE SHIELD
Number 510-91197
State AL

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
32FH9 Active Non-Manufacturer 2004-10-07 2024-07-19 2029-07-19 2025-07-17

Contact Information
POC CHARLES BUMPUS
Phone +1 205-368-2245
Fax +1 205-320-4926
Address 532A SPARKMAN ST SW, HARTSELLE, AL, 35640 3120, 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
LIFECARE OF ALABAMA 401(K) PLAN 2012 631236624 2013-06-05 LIFECARE OF ALABAMA, INC. 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-09-01
Business code 621900
Sponsor’s telephone number 2567736035
Plan sponsor’s address 502A SPARKMAN ST SW, HARTSELLE, AL, 356403120

Signature of
Role Plan administrator
Date 2013-06-05
Name of individual signing SUSAN CLINGMAN
Role Employer/plan sponsor
Date 2013-06-05
Name of individual signing SUSAN CLINGMAN
LIFECARE OF ALABAMA 401(K) PLAN 2011 631236624 2012-07-09 LIFECARE OF ALABAMA, INC. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-09-01
Business code 621900
Sponsor’s telephone number 2567736035
Plan sponsor’s address 502A SPARKMAN ST SW, HARTSELLE, AL, 356403120

Plan administrator’s name and address
Administrator’s EIN 631236624
Plan administrator’s name LIFECARE OF ALABAMA, INC.
Plan administrator’s address 502A SPARKMAN ST SW, HARTSELLE, AL, 356403120
Administrator’s telephone number 2567736035

Signature of
Role Plan administrator
Date 2012-07-09
Name of individual signing SUSAN CLINGMAN-BANKS
Role Employer/plan sponsor
Date 2012-07-09
Name of individual signing SUSAN CLINGMAN-BANKS
LIFECARE OF ALABAMA 401(K) PLAN 2010 631236624 2011-07-26 LIFECARE OF ALABAMA, INC. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-09-01
Business code 621900
Sponsor’s telephone number 2567736035
Plan sponsor’s address 502A SPARKMAN ST SW, HARTSELLE, AL, 356403120

Plan administrator’s name and address
Administrator’s EIN 631236624
Plan administrator’s name LIFECARE OF ALABAMA, INC.
Plan administrator’s address 502A SPARKMAN ST SW, HARTSELLE, AL, 356403120
Administrator’s telephone number 2567736035

Signature of
Role Plan administrator
Date 2011-07-26
Name of individual signing SUSAN CLINGMAN
Role Employer/plan sponsor
Date 2011-07-26
Name of individual signing SUSAN CLINGMAN
LIFECARE OF ALABAMA 401(K) PLAN 2009 631236624 2010-07-29 LIFECARE OF ALABAMA, INC. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-09-01
Business code 621900
Sponsor’s telephone number 2567736035
Plan sponsor’s address 502A SPARKMAN ST SW, HARTSELLE, AL, 356403120

Plan administrator’s name and address
Administrator’s EIN 631236624
Plan administrator’s name LIFECARE OF ALABAMA, INC.
Plan administrator’s address 502A SPARKMAN ST SW, HARTSELLE, AL, 356403120
Administrator’s telephone number 2567736035

Signature of
Role Plan administrator
Date 2010-07-29
Name of individual signing SUSAN CLINGMAN
Role Employer/plan sponsor
Date 2010-07-29
Name of individual signing SUSAN CLINGMAN

Incorporator

Name Role
BUMPUS, CHARLES Incorporator

Agent

Name Role
BUMPUS, CHARLES Agent

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
DCA AWARD VA247P1264 2010-07-01 2010-09-30 2010-09-30
Unique Award Key CONT_AWD_VA247P1264_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title AMBULANCE SERVICES - BIRMINGHAM VAMC
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: AMBULANCE SERVICE

Recipient Details
Recipient LIFECARE OF ALABAMA INC
UEI VD5JUU9LRJG3
Legacy DUNS 843349700
Recipient Address UNITED STATES, 532A SPARKMAN ST S, HARTSELLE, 356403120
DO AWARD VA521C05146 2009-10-01 2010-09-30 2010-09-30
Unique Award Key CONT_AWD_VA521C05146_3600_VA247P0461_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title AMBULANCE SERVICES
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: AMBULANCE SERVICE

Recipient Details
Recipient LIFECARE OF ALABAMA INC
UEI VD5JUU9LRJG3
Legacy DUNS 843349700
Recipient Address UNITED STATES, 532A SPARKMAN ST S, HARTSELLE, 356403120
DO AWARD VA521C80429 2008-05-01 2008-06-30 2008-06-30
Unique Award Key CONT_AWD_VA521C80429_3600_VA247P0461_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title AMBULANCE SERVICES.
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: AMBULANCE SERVICE

Recipient Details
Recipient LIFECARE OF ALABAMA INC
UEI VD5JUU9LRJG3
Legacy DUNS 843349700
Recipient Address UNITED STATES, 532A SPARKMAN ST S, HARTSELLE, 356403120
No data IDV VA247P0461 2008-05-01 No data No data
Unique Award Key CONT_IDV_VA247P0461_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title AMBULANCE SERVICES
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: AMBULANCE SERVICE

Recipient Details
Recipient LIFECARE OF ALABAMA INC
UEI VD5JUU9LRJG3
Legacy DUNS 843349700
Recipient Address UNITED STATES, 532A SPARKMAN ST S, HARTSELLE, 356403120
DO AWARD VA5218C10311 2008-04-01 2008-04-30 2008-04-30
Unique Award Key CONT_AWD_VA5218C10311_3600_VA247P0438_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title AMBULANCE SERVICES.
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: AMBULANCE SERVICE

Recipient Details
Recipient LIFECARE OF ALABAMA INC
UEI VD5JUU9LRJG3
Legacy DUNS 843349700
Recipient Address UNITED STATES, 532A SPARKMAN ST S, HARTSELLE, 356403120
No data IDV VA247P0438 2008-04-01 No data No data
Unique Award Key CONT_IDV_VA247P0438_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title AMBULANCE SERVICES
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: AMBULANCE SERVICE

Recipient Details
Recipient LIFECARE OF ALABAMA INC
UEI VD5JUU9LRJG3
Legacy DUNS 843349700
Recipient Address UNITED STATES, 532A SPARKMAN ST S, HARTSELLE, 356403120
No data IDV V247P2463 2008-03-01 No data No data
Unique Award Key CONT_IDV_V247P2463_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title AMBULANCE SERVICE
NAICS Code 485991: SPECIAL NEEDS TRANSPORTATION
Product and Service Codes V225: AMBULANCE SERVICE

Recipient Details
Recipient LIFECARE OF ALABAMA INC
UEI VD5JUU9LRJG3
Legacy DUNS 843349700
Recipient Address UNITED STATES, 532A SPARKMAN ST S, HARTSELLE, 356403120
DO AWARD VA5218C1029 2007-10-01 2008-03-31 2008-03-31
Unique Award Key CONT_AWD_VA5218C1029_3600_V247P2463_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title AMBULANCE SERVICES.
NAICS Code 485991: SPECIAL NEEDS TRANSPORTATION
Product and Service Codes V225: AMBULANCE SERVICE

Recipient Details
Recipient LIFECARE OF ALABAMA INC
UEI VD5JUU9LRJG3
Legacy DUNS 843349700
Recipient Address UNITED STATES, 532A SPARKMAN ST S, HARTSELLE, 356403120
DO AWARD VA5217C1032 2006-10-01 2007-06-30 2007-06-30
Unique Award Key CONT_AWD_VA5217C1032_3600_V247P2463_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title AMBULANCE SERVICES
NAICS Code 485991: SPECIAL NEEDS TRANSPORTATION
Product and Service Codes V225: AMBULANCE SERVICE

Recipient Details
Recipient LIFECARE OF ALABAMA INC
UEI VD5JUU9LRJG3
Legacy DUNS 843349700
Recipient Address UNITED STATES, 532A SPARKMAN ST S, HARTSELLE, 356403120
DO AWARD VA5217C1031 2006-02-01 2006-09-30 2006-09-30
Unique Award Key CONT_AWD_VA5217C1031_3600_V247P2463_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title AMBULANCE SERVICES
NAICS Code 485991: SPECIAL NEEDS TRANSPORTATION
Product and Service Codes V225: AMBULANCE SERVICE

Recipient Details
Recipient LIFECARE OF ALABAMA INC
UEI VD5JUU9LRJG3
Legacy DUNS 843349700
Recipient Address UNITED STATES, 532A SPARKMAN ST S, HARTSELLE, 356403120

Related by officers

BUMPUS, CHARLES

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Related by address

HARTSELLE, AL

Action Products, Inc. B & B Wood Products, Inc. SouthTrust Bank of Morgan County H. & H. Parts Warehouse, Inc. A. J. Hall and Sons Enterprises, Inc. Hampton Bros. Construction Co., Inc. Hartselle Development Company, Inc. Hartselle Aviation Association Hartselle Frozen Foods & Meats, Inc. Hartselle Industries, Inc.

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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