| Name: | HomeTown Hospice, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 18 Feb 2003 (22 years ago) |
| Date of dissolution: | 15 Aug 2022 |
| Entity Number: | 000-227-694 |
| Register Number: | 000227694 |
| ZIP code: | 36545 |
| County: | Clarke |
| Place of Formation: | Clarke County |
| Principal Address: | 1447 COLLEGE AVEJACKSON, AL 36545 |
| Registered Office Street Address: | 150 SHAMROCK DRIVEJACKSON, AL 36545 |
| Authorized Capital: | $2,000 |
| Paid Share Capital: | $1,000 |
Activities
HOSPICE SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427126374 | 2006-11-30 | 2020-08-19 | PO BOX 403, JACKSON, AL, 365450403, US | 23 SHELL RD, SARALAND, AL, 365712202, US | |||||||||||||||||||||||||||
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| Phone | +1 251-246-2727 |
| Fax | 2512462276 |
| Fax | 2514089153 |
Authorized person
| Name | MRS. ANGIE THORNTON |
| Role | OWNER |
| Phone | 2512462727 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| License Number | 11628 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PIC1598E |
| State | AL |
| Name | Role |
|---|---|
| MCCORQUODALE, GAINES C | Agent |
| Name | Role | Address |
|---|---|---|
| MCCORQUODALE, GAINES C. | Director | 150 SHAMROCK DRIVEJACKSON, AL 36545 |
| CARPENTER, TRACEY | Director | 563 WOODYARD ROADLEROY, AL 36548 |
| THORNTON, ANGELA | Director | 1077 ABB ROADCHATON, AL 36518 |
| Name | Role |
|---|---|
| WALKER, TANYA O | Incorporator |
| MCCORQUODALE, GAINES C | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
