| Name: | Mizell Memorial Hospital Incorporated |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 26 Nov 1945 (79 years ago) |
| Entity Number: | 000-817-161 |
| Register Number: | 000817161 |
| County: | Covington |
| Place of Formation: | Covington County |
| Registered Office Street Address: | 702 N MAIN STOPP, AL 36467 |
| Registered Office Street Address ZIP Code: | 36467 |
| Registered Office Mailing Address: | PO BOX 1010OPP, AL 36467 |
| Registered Office Mailing Address ZIP Code: | 36467 |
| Principal Address: | OPP, AL 36467 |
| Principal Address ZIP Code: | 36467 |
Activities
OPERATE HOSPITAL
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| H6P9LZQM7RP5 | 2025-03-26 | 702 N MAIN ST, OPP, AL, 36467, 1626, USA | P O BOX 1010, OPP, AL, 36467, 1010, USA | |||||||||||||||||||||||||||||||||||||||||||
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| URL | www.mizellmh.com |
| Congressional District | 02 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2024-04-01 |
| Initial Registration Date | 2010-07-30 |
| Entity Start Date | 1945-11-26 |
| Fiscal Year End Close Date | Sep 30 |
Service Classifications
| NAICS Codes | 622110 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | JANA WYATT |
| Role | CFO |
| Address | P.O. BOX 1010, 702 N. MAIN STREET, OPP, AL, 36467, 1010, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | JANA WYATT |
| Role | CFO |
| Address | P.O. BOX 1010, 702 N. MAIN STREET, OPP, AL, 36467, 1010, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710749981 | 2024-01-24 | 2024-03-26 | PO BOX 1010, OPP, AL, 364671010, US | 702 N MAIN ST STE 2, OPP, AL, 364671626, US | |||||||||||||||||||||||
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| Phone | +1 334-493-5704 |
| Fax | 3344939664 |
Authorized person
| Name | JANA WYATT |
| Role | CFO |
| Phone | 3344935790 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 261QC1500X - Community Health Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | Yes |
| CAGE number | Status | Type | Established | CAGE Update Date | CAGE Expiration | SAM Expiration | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 631R9 | Active | Non-Manufacturer | 2010-08-02 | 2024-04-01 | 2029-04-01 | 2025-03-26 | |||||||||||||||
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| POC | JANA WYATT |
| Phone | +1 334-493-5790 |
| Fax | +1 334-493-3789 |
| Address | 702 N MAIN ST, OPP, COVINGTON, AL, 36467 1626, 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 |
|---|---|
| WYATT, JANA | Agent |
| Name | Role |
|---|---|
| LOYON, F M | Incorporator |
| FOSTER, J C JR | Incorporator |
| DANLEY, H D | Incorporator |
| MACLENNON, E R | Incorporator |
| WATERS, H W SR | Incorporator |
| HURST, J C | Incorporator |
| PIERCE, G C | Incorporator |
| JEFFCOAT, R S | Incorporator |
| CHANNELL, J L SR | Incorporator |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
