| Name: | Sumter Health and Rehabilitation, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 02 Dec 1999 (25 years ago) |
| Entity Number: | 000-667-456 |
| Register Number: | 000667456 |
| Historical Names: |
Northport Health Services of Alabama, L.L.C.
|
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 420 NORTH TWENTIETH ST STE 3100BIRMINGHAM, AL 35203 |
| Registered Office Street Address ZIP Code: | 35203 |
Activities
OPERATE/OWN SKILLED CARE NURSING FACILITIES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497702260 | 2006-05-27 | 2020-10-12 | 1505 E 4TH AVE, YORK, AL, 369252940, US | 1505 E 4TH AVE, YORK, AL, 369252940, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 205-392-5281 |
Authorized person
| Name | PHILLIP CODY LONG |
| Role | CFO |
| Phone | 2053913600 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS ID |
| Number | 010589 |
| State | AL |
| Issuer | MEDICAID |
| Number | 4750420S |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CHRISTIAN, EDWARD R | Agent | 420 20TH ST N STE 3400BIRMINGHAM, AL 35203 |
| Name | Role |
|---|---|
| NORTHPORTH HEALTH SERVICES OF | Member |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 1999-12-21 | Name Change | Northport Health Services of Alabama, L.L.C. | Sumter Health and Rehabilitation, L.L.C. |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
