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Fort Payne Hospital Corporation

Details

Name: Fort Payne Hospital Corporation
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 23 Feb 2006 (19 years ago) (Companies founded in February 2006)
Entity Number: 000-245-903
Register Number: 000245903
ZIP code: 36104 (Companies in Montgomery, 36104)
County: Montgomery
Place of Formation: Montgomery County
Principal Address: MONTGOMERY, AL
Registered Office Street Address: 2 NORTH JACKSON STREET SUITE 605MONTGOMERY, AL 36104
Authorized Capital: $10

Activities HOSPITAL/HEALTH CARE FACILITY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1255959144 2020-07-08 2020-07-08 1573 MALLORY LN STE 200, BRENTWOOD, TN, 370272895, US 200 MEDICAL CENTER DR SW, FORT PAYNE, AL, 359683458, US

Contacts

Phone +1 615-221-3758
Fax 6152211456
Phone +1 256-845-3150
Fax 2569972512

Authorized person

Name RANDY MICHAEL COOPER
Role AUTHORIZED OFFICIAL
Phone 6152213840

Taxonomy

Taxonomy Code 275N00000X - Medicare Defined Swing Bed Hospital Unit
Is Primary Yes

Incorporator

Name Role
KECK, ROBIN J Incorporator

Agent

Name Role Address
CT CORPORATION SYSTEM Agent 6190 POWERS FERRY RD STE 600ATLANTA, GA 30339

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State