| Name: | Alpha Home Medical, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 15 Feb 2005 (20 years ago) |
| Date of dissolution: | 10 Sep 2018 |
| Entity Number: | 000-460-498 |
| Register Number: | 000460498 |
| County: | Dallas |
| Place of Formation: | Dallas County |
| Principal Address: | SELMA, AL |
| Registered Office Street Address: | 173 CO RD 843SELMA, AL 36701 |
| Registered Office Street Address ZIP Code: | 36701 |
Activities
WHOLESALE/RETAIL MEDICAL EQUIPMENT
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972666733 | 2006-12-19 | 2020-08-22 | 2700 CITIZENS PKWY, SELMA, AL, 367014013, US | 2700 CITIZENS PKWY, SELMA, AL, 367014013, US | |||||||||||||||||||||||||
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| Phone | +1 334-874-1183 |
| Fax | 3348741184 |
Authorized person
| Name | MRS. SHIRLEY A MOSELEY |
| Role | OWNER |
| Phone | 3348741183 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 639 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS OF AL PROVIDER |
| Number | 51528398 |
| State | AL |
| Name | Role |
|---|---|
| MOSELEY, SHIRLEY ANN | Agent |
| Name | Role |
|---|---|
| MOSELEY, SHIRLEY ANN | Member |
| MOSELEY, ROBERT L JR | Member |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
