| Name: | Health Services Diversified, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 15 Mar 2000 (25 years ago) |
| Date of dissolution: | 31 Oct 2019 |
| Entity Number: | 000-208-680 |
| Register Number: | 000208680 |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Principal Address: | FAIRHOPE, AL |
| Registered Office Street Address: | 203 NORTH CIRCLEFAIRHOPE, AL 36532 |
| Registered Office Street Address ZIP Code: | 36532 |
| Authorized Capital: | $1,000 |
Activities
PHARMACY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124043963 | 2006-07-13 | 2008-07-24 | 104 ECOR ROUGE PL, FAIRHOPE, AL, 365323062, US | 104 ECOR ROUGE PL, FAIRHOPE, AL, 365323062, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 251-929-1017 |
| Fax | 2519291018 |
Authorized person
| Name | DR. JODI C. SILVIO |
| Role | PRESIDENT |
| Phone | 2519291017 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 111749 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 332BP3500X - Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | 111749 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | 111749 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 111749 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 3336H0001X - Home Infusion Therapy Pharmacy |
| License Number | 111749 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| License Number | 111749 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 3336M0002X - Mail Order Pharmacy |
| License Number | 111749 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 100003187 |
| State | AL |
| Issuer | MEDICAID |
| Number | 009938825 |
| State | AL |
| Name | Role |
|---|---|
| SILVIO, JODI | Agent |
| Name | Role |
|---|---|
| SILVIO, JODI | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
