| Name: | Mercy Medical, A Corporation |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Merged |
| Date of registration: | 13 Feb 1962 (63 years ago) |
| Entity Number: | 000-771-093 |
| Register Number: | 000771093 |
| Historical Names: |
Villa Mercy
|
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Principal Address: | 374 GREENO ROADFAIRHOPE, AL 36532 |
| Principal Address ZIP Code: | 36532 |
| Registered Office Street Address: | 2 NORTH JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
Activities
PROMOTE CATHOLIC HEALTHCARE MISSION OF THE SISTERS OF MERCY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215992524 | 2006-04-19 | 2007-07-13 | PO BOX 1090, DAPHNE, AL, 365261090, US | 3712 DAUPHIN ST, MOBILE, AL, 366081725, US | |||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||
| Phone | +1 251-344-7126 |
Authorized person
| Name | MARY KAY POLYS |
| Role | CHIEF EXECUTIVE OFFICER |
| Phone | 2516214223 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| License Number | 12631 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BC DSF SNF PROVIDER NUMBE |
| Number | 012353 |
| State | AL |
| Issuer | BC SNF PROVIDER NUMBER |
| Number | 010347 |
| State | AL |
| Issuer | HEALTHSPRING PROVIDER NUM |
| Number | 9245 |
| State | AL |
| CAGE number | Status | Type | Established | CAGE Update Date | CAGE Expiration | SAM Expiration | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 7C3Z3 | Active | Non-Manufacturer | 2015-03-20 | 2021-11-10 | 2025-11-10 | 2021-11-10 | |||||||||||||
|
|||||||||||||||||||
| POC | DONNA WILHELM |
| Phone | +1 251-504-7353 |
| Address | 2900 SPRINGHILL AVE, MOBILE, AL, 36607 1822, 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 |
|---|
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 6190 POWERS FERRY RD STE 600ATLANTA, GA 30339 |
| Name | Role |
|---|---|
| DUFFY RSM, MOTHER MARY CARLOTTA | Incorporator |
| WHITE RSM, SISTER MARY CECILIANA | Incorporator |
| LEECH RSM, SISTER MARIA | Incorporator |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2017-03-06 | Name Merged | No data | Mercy LIFE of Birmingham |
| 1987-02-06 | Name Change | Villa Mercy | Mercy Medical, A Corporation |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
