| Name: | Hospice of West Alabama, Incorporated |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 22 Apr 1980 (45 years ago) |
| Entity Number: | 000-819-986 |
| Register Number: | 000819986 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Registered Office Street Address: | 3851 LOOP ROADTUSCALOOSA, AL 35404 |
| Registered Office Street Address ZIP Code: | 35404 |
| Principal Address: | TUSCALOOSA, AL |
Activities
SERVICES FOR TERMINALLY ILL PATIENTS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861497935 | 2005-06-16 | 2012-07-12 | 3851 LOOP RD, TUSCALOOSA, AL, 354045040, US | 3851 LOOP RD, TUSCALOOSA, AL, 354045040, US | |||||||||||||||||||||||||||||||
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| Phone | +1 205-523-0101 |
| Fax | 2055230102 |
Authorized person
| Name | MRS. LATRELLE PORTER BELL |
| Role | EXECUTIVE DIRECTOR |
| Phone | 2055230101 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| License Number | 10278 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PIC1517E |
| State | AL |
| Issuer | BLUE CROSS/BLUE SHEILD |
| Number | 010497 |
| State | AL |
| Name | Role |
|---|---|
| LATRELLE HALLUM | Agent |
| Name | Role | Address |
|---|---|---|
| PAUL, MAURICE B | Incorporator | No data |
| COLEMAN, SUE | Incorporator | 2553 MOUNTAIN WOODS DRIVEBIRMINGHAM, AL 35216 |
| HOFF, TIMOTHY | Incorporator | No data |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
