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Affinity Hospital, LLC

Details

Name: Affinity Hospital, LLC
Jurisdiction: Alabama
Legal type: Foreign Limited Liability Company
Status: Exists
Date of registration: 30 Aug 2005 (19 years ago)
Entity Number: 000-609-100
Register Number: 000609100
County: Montgomery
Place of Formation: Delaware
Principal Address: 4000 MERIDIAN BLVDFRANKLIN, TN 37067
Principal Mailing Address: 600 MADISON AVENUE 8TH FLOORNEW YORK, NY 10022
Registered Office Street Address: 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104
Registered Office Street Address ZIP Code: 36104

Activities HEALTH CARE SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1851582613 2007-08-07 2007-10-27 PO BOX 403804, ATLANTA, GA, 303843084, US 800 MONTCLAIR RD, BIRMINGHAM, AL, 352131908, US

Contacts
Phone +1 205-592-1488
Fax 2055921200
Fax 2055925653

Authorized person
Name DEBBIE A. BREWER
Role AUTHORIZED PERSON
Phone 8778929813

Taxonomy
Taxonomy Code 133N00000X - Nutritionist
Is Primary No
Taxonomy Code 133NN1002X - Nutrition Education Nutritionist
Is Primary Yes
Taxonomy Code 133V00000X - Registered Dietitian
Is Primary No

Other Provider Identifiers
Issuer MEDICAID
Number PENDING
State AL

Central Index Key

CIK number Mailing Address Business Address Phone
1445439 4000 MERIDIAN BLVD, FRANKLIN, TN, 37067 800 MONTCLAIR ROAD, BIRMINGHAM, AL, 35213 615-465-7361

Filings since 2019-03-12
Form type S-3ASR
File number 333-230221-06
Filing date 2019-03-12
File View File

Filings since 2017-05-11
Form type 424B5
File number 333-203918-139
Filing date 2017-05-11
File View File

Filings since 2017-05-09
Form type 424B5
File number 333-203918-139
Filing date 2017-05-09
File View File

Filings since 2017-03-09
Form type 424B5
File number 333-203918-139
Filing date 2017-03-09
File View File

Filings since 2017-03-07
Form type 424B5
File number 333-203918-139
Filing date 2017-03-07
File View File

Filings since 2017-03-03
Form type POSASR
File number 333-203918-139
Filing date 2017-03-03
File View File

Filings since 2015-05-06
Form type S-3ASR
File number 333-203918-139
Filing date 2015-05-06
File View File

Filings since 2014-09-26
Form type 424B3
File number 333-198801-260
Filing date 2014-09-26
File View File

Filings since 2014-09-25
Form type EFFECT
File number 333-198801-260
Filing date 2014-09-25
File View File

Filings since 2014-09-17
Form type S-4
File number 333-198801-260
Filing date 2014-09-17
File View File

Filings since 2012-08-09
Form type 424B5
File number 333-181630-01
Filing date 2012-08-09
File View File

Filings since 2012-08-08
Form type 424B5
File number 333-181630-01
Filing date 2012-08-08
File View File

Filings since 2012-07-10
Form type 424B5
File number 333-181630-01
Filing date 2012-07-10
File View File

Filings since 2012-07-09
Form type 424B5
File number 333-181630-01
Filing date 2012-07-09
File View File

Filings since 2012-06-07
Form type POSASR
File number 333-181630-01
Filing date 2012-06-07
File View File

Filings since 2012-05-24
Form type S-3ASR
File number 333-181630-01
Filing date 2012-05-24
File View File

Filings since 2008-12-22
Form type S-3ASR
File number 333-156405-153
Filing date 2008-12-22
File View File

Agent

Name Role Address
CORPORATION SERVICE COMPANY INC Agent 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
PO AWARD DJBP0313LB210024 2012-01-19 2012-02-28 2012-03-30
Unique Award Key CONT_AWD_DJBP0313LB210024_1540_-NONE-_-NONE-
Awarding Agency Department of Justice
Link View Page

Description
Title EMERGENCY MEDICAL TREATMENT.
NAICS Code 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product and Service Codes Q999: MEDICAL- OTHER

Recipient Details
Recipient AFFINITY HOSPITAL, LLC
UEI WH5XXLWN8ET5
Legacy DUNS 124782116
Recipient Address UNITED STATES, 800 MONTCLAIR RD, BIRMINGHAM, 352131908
PO AWARD DJBP0313KB210095 2011-08-25 2011-08-25 2011-08-25
Unique Award Key CONT_AWD_DJBP0313KB210095_1540_-NONE-_-NONE-
Awarding Agency Department of Justice
Link View Page

Description
Title EMERGENCY MEDICAL TREATMENT. PHYSICIAN CHARGES.
NAICS Code 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product and Service Codes Q999: OTHER MEDICAL SERVICES

Recipient Details
Recipient AFFINITY HOSPITAL, LLC
UEI WH5XXLWN8ET5
Legacy DUNS 124782116
Recipient Address UNITED STATES, 800 MONTCLAIR RD, BIRMINGHAM, 352131908
PO AWARD DJBP0313KB210090 2011-04-19 2011-05-18 2011-05-18
Unique Award Key CONT_AWD_DJBP0313KB210090_1540_-NONE-_-NONE-
Awarding Agency Department of Justice
Link View Page

Description
Title EMERGENCY MEDICAL TREATMENT.
NAICS Code 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product and Service Codes Q999: OTHER MEDICAL SERVICES

Recipient Details
Recipient AFFINITY HOSPITAL, LLC
UEI WH5XXLWN8ET5
Legacy DUNS 124782116
Recipient Address UNITED STATES, 800 MONTCLAIR RD, BIRMINGHAM, 352131908
DCA AWARD VA247P1002 2009-08-01 2010-07-31 2012-07-31
Unique Award Key CONT_AWD_VA247P1002_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title INPATIENT MENTAL HEALTH
NAICS Code 621330: OFFICES OF MENTAL HEALTH PRACTITIONERS (EXCEPT PHYSICIANS)
Product and Service Codes Q999: OTHER MEDICAL SERVICES

Recipient Details
Recipient AFFINITY HOSPITAL, LLC
UEI WH5XXLWN8ET5
Legacy DUNS 124782116
Recipient Address UNITED STATES, 800 MONTCLAIR RD, BIRMINGHAM, 352131908

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4000 MERIDIAN BLVDFRANKLIN, TN 37067

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Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State

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