| Name: | Mid-South Home Health of Gadsden, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 07 Jun 2004 (20 years ago) |
| Entity Number: | 000-927-616 |
| Register Number: | 000927616 |
| Historical Names: |
Mid-South Home Health of Gadsden, Inc.
|
| County: | Montgomery |
| Place of Formation: | Georgia |
| Principal Address: | 3350 RIVERWOOD PKY STE 1400ATLANTA, GA 30339 |
| Registered Office Street Address: | 2 NORTH JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CMJBJ3E9PZ43 | 2025-03-18 | 716 GAULT AVE N, FORT PAYNE, AL, 35967, 2628, USA | PO BOX 99767, CHICAGO, IL, 60696, 7467, USA | |||||||||||||||||||||||||||||||||||||||
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| Congressional District | 04 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2024-03-19 |
| Initial Registration Date | 2022-01-21 |
| Entity Start Date | 2013-01-03 |
| Fiscal Year End Close Date | Dec 31 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | DEBRA CARDIFF |
| Role | BILLING ANALYST |
| Address | PO BOX 99767, CHICAGO, IL, 60696, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | DEBRA CARDIFF |
| Role | BILLING ANALYST |
| Address | PO BOX 99767, CHICAGO, IL, 60696, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740219591 | 2006-07-02 | 2022-09-03 | 6330 SPRINT PKWY STE 300, OVERLAND PARK, KS, 662111157, US | 3225 RAINBOW DR STE 256, RAINBOW CITY, AL, 359065861, US | |||||||||||||||||||||||
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| Phone | +1 256-442-1138 |
Authorized person
| Name | JOHN NICHOLS |
| Role | AUTHORIZED SIGNATORY |
| Phone | 2564421138 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | MID7018A |
| State | AL |
| Issuer | G2 |
| Number | 51525568 |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2013-01-04 | Name Change | Mid-South Home Health of Gadsden, Inc. | Mid-South Home Health of Gadsden, LLC |
| 2005-06-30 | Name Merged | No data | Riverview Home Health Agency, LLC |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
