| Name: | AseraCare Hospice - Jackson, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 24 May 2004 (21 years ago) (Companies founded in May 2004) |
| Entity Number: | 000-606-753 |
| Register Number: | 000606753 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | ONE THOUSAND BEVERLY WAYFORT SMITH, AR 72919 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
Activities
HOSPICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790115756 | 2013-11-12 | 2020-07-06 | 3854 AMERICAN WAY STE A, BATON ROUGE, LA, 708164897, US | 1201 MONTLIMAR DR, STE 100, MOBILE, AL, 366091704, US | |||||||||||||||||||||||||||||
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| Phone | +1 225-292-2031 |
| Fax | 2252959678 |
| Phone | +1 251-343-0989 |
Authorized person
| Name | PAUL KUSSEROW |
| Role | PRESIDENT |
| Phone | 2252922031 |
Taxonomy
| Taxonomy Code | 207PH0002X - Hospice and Palliative Medicine (Emergency Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 207QH0002X - Hospice and Palliative Medicine (Family Medicine) Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RH0002X - Hospice and Palliative Medicine (Internal Medicine) Physician |
| Is Primary | No |
| Taxonomy Code | 2081H0002X - Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician |
| Is Primary | No |
| CAGE number | Status | Type | Established | CAGE Update Date | CAGE Expiration | SAM Expiration | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7C8A2 | Obsolete | Non-Manufacturer | 2015-03-26 | 2024-09-21 | 2024-09-20 | No data | |||||||||||||||||||||
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| POC | NANCY ANDERSON |
| Phone | +1 479-358-9966 |
| Address | 4115 N COLLEGE AVE, JACKSON, AL, 36545 2022, UNITED STATES |
Ownership of Offeror Information
| Highest Level Owner | Information not Available |
|---|
| Immediate Level Owner | |
|---|---|
| Vendor Certified | 2019-09-20 |
| CAGE number | 7KZ40 |
| Company Name | HOSPICE OF EASTERN CAROLINA, INC. |
| CAGE Last Updated | 2024-07-02 |
| List of Offerors (0) | Information not Available |
|---|
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
