| Name: | Greater Alabama Health Network, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 18 Feb 2005 (20 years ago) |
| Entity Number: | 000-561-387 |
| Register Number: | 000561387 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Principal Address: | TUSCALOOSA, AL |
| Registered Office Street Address: | 921 PROFESSIONAL PLAZATUSCALOOSA, AL 35401 |
| Registered Office Street Address ZIP Code: | 35401 |
Activities
CHARITABLE PURPOSES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609104199 | 2009-11-23 | 2009-11-23 | 921 PROFESSIONAL PLZ, TUSCALOOSA, AL, 354017418, US | 921 PROFESSIONAL PLZ, TUSCALOOSA, AL, 354017418, US | |||||||||||||||||||||
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| Phone | +1 205-345-1905 |
| Fax | 2053452909 |
Authorized person
| Name | MRS. BECKY HENDERSON |
| Role | PROGRAM DIRECTOR |
| Phone | 2053451905 |
Taxonomy
| Taxonomy Code | 302F00000X - Exclusive Provider Organization |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 580500004 |
| State | AL |
| Name | Role |
|---|---|
| HENDERSON, BECKY J | Agent |
| Name | Role | Address |
|---|---|---|
| STEWART, WILLIAM B | Incorporator | 800 SHADES CREEK PARKWAY, SUITE 400BIRMINGHAM, AL 35209-1196 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
