| Name: | DeKalb County Hospital Association |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 23 Jan 1946 (79 years ago) (Companies founded in January 1946) |
| Entity Number: | 000-734-170 |
| Register Number: | 000734170 |
| Place of Formation: | DeKalb County |
| Principal Address: | ---, AL |
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| UMHLN8NYL9T6 | 2025-04-15 | 208 AIRPORT RD W, FORT PAYNE, AL, 35968, 3335, USA | PO BOX 680643, FORT PAYNE, AL, 35968, USA | |||||||||||||||||||||||||||||||||||||||
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| Division Name | DEKALB AMBULANCE SERVICE |
| Congressional District | 04 |
| Activation Date | 2024-04-17 |
| Initial Registration Date | 2012-08-27 |
| Entity Start Date | 1986-12-01 |
| Fiscal Year End Close Date | Dec 31 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | CHERYL D TURNER |
| Role | EXECUTIVE DIRECTOR |
| Address | PO BOX 680643, FORT PAYNE, AL, 35968, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | ANDREA WILLIAMS |
| Role | DIRECTOR OF FINANCE |
| Address | PO BOX 680643, FORT PAYNE, AL, 35968, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013098300 | 2006-10-17 | 2011-11-29 | PO BOX 680643, FORT PAYNE, AL, 359681607, US | 208 AIRPORT RD W, FORT PAYNE, AL, 359683335, US | |||||||||||||||||||||||||
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| Phone | +1 256-845-4027 |
| Fax | 2568455860 |
Authorized person
| Name | MS. ANDREA B WILLIAMS |
| Role | CHIEF FINANCIAL OFFICER |
| Phone | 2568454027 |
Taxonomy
| Taxonomy Code | 3416L0300X - Land Ambulance |
| License Number | 202 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 200025108 |
| State | AL |
| CAGE number | Status | Type | Established | CAGE Update Date | CAGE Expiration | SAM Expiration | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 6H4Q5 | Active | Non-Manufacturer | 2012-09-25 | 2024-04-17 | 2029-04-17 | 2025-04-15 | |||||||||||||||
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| POC | ANDREA WILLIAMS |
| Phone | +1 256-845-4027 |
| Fax | +1 256-845-5860 |
| Address | 208 AIRPORT RD W, FORT PAYNE, AL, 35968 3335, UNITED STATES |
Ownership of Offeror Information
| Highest Level Owner | Information not Available |
|---|
| Immediate Level Owner | Information not Available |
|---|
| List of Offerors (0) | Information not Available |
|---|
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
