| Name: | Pickens County Health Care Authority |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 28 Sep 2012 (12 years ago) (Companies founded in September 2012) |
| Entity Number: | 000-268-801 |
| Register Number: | 000268801 |
| ZIP code: | 35447 (Companies in Pickens, 35447) |
| County: | Pickens |
| Place of Formation: | Pickens County |
| Principal Address: | 241 ROBERT K WILSON DRIVECARROLLTON, AL 35447 |
Activities
OWN
EQUIP
AND OPERATE PUBLIC HOSPITALS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134473770 | 2012-11-05 | 2012-11-05 | P. O. BOX 478, 96 COURT SQUARE, CARROLLTON, AL, 35447, US | 96 COURT SQUARE, CARROLLTON, AL, 35447, US | |||||||||||||||||||||||
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| Phone | +1 205-367-1234 |
Authorized person
| Name | MRS. SHARON D. HAMLIN |
| Role | ASSISTANT ADMINISTRATOR OPERATIONS |
| Phone | 2053672442 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 677 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009603260 |
| State | AL |
| CAGE number | Status | Type | Established | CAGE Update Date | CAGE Expiration | SAM Expiration | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7MH60 | Obsolete | Non-Manufacturer | 2016-05-20 | 2023-12-18 | 2023-12-17 | No data | |||||||||||||
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| POC | RICHARD MCBRYDE |
| Phone | +1 205-367-2401 |
| Address | 241 ROBERT K WILSON DR, CARROLLTON, AL, 35447 8032, UNITED STATES |
Ownership of Offeror Information
| Highest Level Owner | Information not Available |
|---|
| Immediate Level Owner | Information not Available |
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| List of Offerors (0) | Information not Available |
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Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
