| Name: | Clay County Hospital Home Care, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 29 Sep 2004 (20 years ago) (Companies founded in September 2004) |
| Entity Number: | 000-455-846 |
| Register Number: | 000455846 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Jefferson County |
| Principal Address: | MONTGOMERY, AL |
| Registered Office Street Address: | 2 NORTH JACKSON STREET, SUITE 605MONTGOMERY, AL 36104 |
Activities
OWN/OPERATE/MANAGE A MEDICARE-CERTIFIED HOME HEALTH AGENCY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861575334 | 2006-10-20 | 2024-05-24 | PO BOX 51266, LAFAYETTE, LA, 705051266, US | 83825 HIGHWAY 9, ASHLAND, AL, 36251, US | |||||||||||||||||||||||||||||||
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| Phone | +1 337-233-1307 |
| Fax | 3372335764 |
| Phone | +1 256-354-0077 |
| Fax | 2563540081 |
Authorized person
| Name | MR. JOSHUA L. PROFFITT |
| Role | PRESIDENT |
| Phone | 3372331307 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD OF |
| Number | 515-31377 |
| State | AL |
| Issuer | MEDICAID |
| Number | CLA 7097A |
| State | AL |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
| Name | Role |
|---|---|
| THE CLAY CO HEALTH CARE AUTHORITY | Member |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
