| Name: | Faith Hospice Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 13 Feb 2001 (24 years ago) |
| Date of dissolution: | 26 Mar 2007 |
| Entity Number: | 000-214-819 |
| Register Number: | 000214819 |
| County: | Tallapoosa |
| Place of Formation: | Tallapoosa County |
| Principal Address: | ALEXANDER CITY, AL |
| Registered Office Street Address: | 526 PARK PLACEALEXANDER CITY, AL 35010 |
| Registered Office Street Address ZIP Code: | 35010 |
| Authorized Capital: | $2,000 |
| Paid Share Capital: | $2,000 |
Activities
PROVIDE COMFORT/CARE/MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356307904 | 2006-04-24 | 2020-08-22 | 625 ALEX CITY SHOPPING CTR DR, ALEXANDER CITY, AL, 350102787, US | 625 ALEX CITY SHOPPING CTR DR, ALEXANDER CITY, AL, 350102787, US | |||||||||||||||||||||||||||||
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| Phone | +1 256-215-6006 |
Authorized person
| Name | MR. CHARLES WAYNE WILLARD SR. |
| Role | PRESIDENT / CEO |
| Phone | 2562156006 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| License Number | 11748 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS PREFERRED |
| Number | 012-250 |
| State | AL |
| Issuer | MEDICAID |
| Number | PIC1581E |
| State | AL |
| Name | Role |
|---|---|
| WILLARD, WAYNE | Agent |
| Name | Role |
|---|---|
| WILLARD, WAYNE | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
