| Name: | Hospice of the Shoals, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Dissolved |
| Date of registration: | 20 Apr 1982 (43 years ago) |
| Date of dissolution: | 09 Dec 2019 |
| Entity Number: | 000-755-625 |
| Register Number: | 000755625 |
| Place of Formation: | Lauderdale County |
| Principal Address: | FLORENCE, AL |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750329355 | 2006-06-04 | 2020-08-22 | 115 FAIRGROUND RD, FLORENCE, AL, 356301283, US | 115 FAIRGROUND RD, FLORENCE, AL, 356301283, US | |||||||||||||||||||||||||||||||
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| Phone | +1 256-767-6699 |
| Fax | 2567673116 |
Authorized person
| Name | MR. RALPH N CAGLE JR. |
| Role | PRESIDENT/CEO |
| Phone | 2567676699 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| License Number | 11688 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PIC1530E |
| State | AL |
| Issuer | BLUE CROSS/BLUE SHIELD |
| Number | 43113 |
| State | AL |
| Name | Role |
|---|---|
| PERRYMAN, VIRGINIA T | Incorporator |
| AHRENS, BETTY | Incorporator |
| ARRINGTON, ALICE D | Incorporator |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
