| Name: | Palliative and Supportive Care Alliance |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 02 May 2013 (11 years ago) |
| Entity Number: | 000-281-612 |
| Register Number: | 000281612 |
| County: | Marshall |
| Place of Formation: | Marshall County |
| Registered Office Mailing Address: | PO BOX 1875ALBERTVILLE, AL 35950 |
| Registered Office Mailing Address ZIP Code: | 35950 |
Activities
PROVIDE PALLIATIVE CARE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225457757 | 2014-04-11 | 2016-04-29 | 408 MARTLING RD STE A-105, ALBERTVILLE, AL, 359517208, US | 408 MARTLING RD STE A-105, ALBERTVILLE, AL, 359517208, US | |||||||||||||||||||
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| Phone | +1 256-302-1663 |
| Fax | 2562790534 |
Authorized person
| Name | MRS. STORMY DENISE DISMUKE |
| Role | CEO |
| Phone | 2563021633 |
Taxonomy
| Taxonomy Code | 207QH0002X - Hospice and Palliative Medicine (Family Medicine) Physician |
| License Number | 1-084124 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WELLS, NORMA M | Agent | 1640 BLOUNT AVENUEGUNTERSVILLE, AL 35976 |
| Name | Role | Address |
|---|---|---|
| RATCLIFFE, ALFRED A JR | Incorporator | 135 PEBBLE BROOK DRIVEALBERTVILLE, AL 35951 |
| WELLS, NORMA M | Incorporator | 1640 BLOUNT AVENUEGUNTERSVILLE, AL 35976 |
| OSBORNE, RHONDA | Incorporator | 2625 SOLITUDE ROADALBERTVILLE, AL 35950 |
| Name | Role | Address |
|---|---|---|
| POWELL, HOLLIE | Director | No data |
| SPARKMAN, CINDY | Director | No data |
| OSBORNE, RHONDA | Director | 2625 SOLITUDE ROADALBERTVILLE, AL 35950 |
| RATCLIFFE, ALFRED A JR | Director | 135 PEBBLE BROOK DRIVEALBERTVILLE, AL 35951 |
| WELLS, NORMA M | Director | 1640 BLOUNT AVENUEGUNTERSVILLE, AL 35976 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
