| Name: | Sacred Heart Health System, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 25 Feb 1963 (62 years ago) (Companies founded in February 1963) |
| Entity Number: | 000-913-282 |
| Register Number: | 000913282 |
| Historical Names: |
Sacred Heart Hospital of Pensacola
|
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Florida |
| Principal Address: | 5151 N 9TH AVEPENSACOLA, FL 32513-2700 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1841343340 | 2007-01-19 | 2020-08-22 | 6701 AIRPORT BLVD, SUITE 143, MOBILE, AL, 366086705, US | 6701 AIRPORT BLVD, SUITE 143, MOBILE, AL, 366086705, US | |||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||
| Phone | +1 850-470-9288 |
| Fax | 8504709130 |
Authorized person
| Name | MRS. CONSTANCE HETTERICH |
| Role | ADMINISTRATOR |
| Phone | 8504709288 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 2006-004168 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS AL - DME |
| Number | 51503539 |
| State | FL |
| Issuer | MEDICAID |
| Number | 02078367 |
| State | MS |
| Issuer | UNITED HEALTH CARE |
| Number | 8200162 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2005-01-06 | Name Change | Sacred Heart Hospital of Pensacola | Sacred Heart Health System, Inc. |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
