| Name: | Affinity Healthcare Services, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 20 Sep 2004 (20 years ago) |
| Entity Number: | 000-237-375 |
| Register Number: | 000237375 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Principal Address: | TUSCALOOSA, AL |
| Registered Office Street Address: | 1546 MORGAN DRTUSCALOOSA, AL 35405 |
| Registered Office Street Address ZIP Code: | 35405 |
| Authorized Capital: | 5,000 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477642197 | 2006-10-12 | 2020-08-22 | 140 OXMOOR BLVD, SUITE 170, BIRMINGHAM, AL, 352095986, US | 140 OXMOOR BLVD, SUITE 170, BIRMINGHAM, AL, 352095986, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 205-949-0400 |
| Fax | 2059490405 |
Authorized person
| Name | MRS. SANDRA R MCKENZIE |
| Role | PRESIDENT AND CEO |
| Phone | 2059490400 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| License Number | 11682 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 012-00577 |
| State | AL |
| Issuer | MEDICAID |
| Number | PIC1624E |
| State | AL |
| Name | Role |
|---|---|
| MCKENZIE, DEVIN B | Agent |
| Name | Role |
|---|---|
| MCKENZIE, SANDRA R | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
