| Name: | Clarke County Healthcare, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 15 Sep 2003 (21 years ago) |
| Entity Number: | 000-605-853 |
| Register Number: | 000605853 |
| County: | Clarke |
| Place of Formation: | Georgia |
| Principal Address: | 33700 HWY 43THOMASVILLE, AL 36784 |
| Principal Address ZIP Code: | 36784 |
Activities
HOSPITAL & HEALTHCARE SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336139401 | 2005-10-28 | 2022-07-21 | 33700 HIGHWAY 43, THOMASVILLE, AL, 367843335, US | 33700 HIGHWAY 43, THOMASVILLE, AL, 367843335, US | |||||||||||||||||||||||
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| Phone | +1 334-636-4431 |
| Fax | 3346366129 |
Authorized person
| Name | MS. LORA TILLMAN |
| Role | OFFICE MANAGER |
| Phone | 3346364431 |
Taxonomy
| Taxonomy Code | 282E00000X - Long Term Care Hospital |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 282N00000X - General Acute Care Hospital |
| State | AL |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CLARKE COUNTY HEALTHCARE, LLC | 2013 | 200288194 | 2014-10-13 | CLARKE COUNTY HEALTHCARE, LLC | 53 | |||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2014-10-13 |
| Name of individual signing | ANNE THOMPSON |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2009-08-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3346364431 |
| Plan sponsor’s address | 33700 HWY 43, THOMASVILLE, AL, 36784 |
Signature of
| Role | Plan administrator |
| Date | 2013-07-15 |
| Name of individual signing | ANNE THOMPSON |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2009-08-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3346364431 |
| Plan sponsor’s address | 33700 HWY 43, THOMASVILLE, AL, 36784 |
Signature of
| Role | Plan administrator |
| Date | 2013-07-30 |
| Name of individual signing | ANNE THOMPSON |
| Name | Role |
|---|---|
| SIMS, LISA | Agent |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
