| Name: | Centre Hospital Corporation |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 23 Feb 2006 (19 years ago) |
| Date of dissolution: | 14 Jan 2019 |
| Entity Number: | 000-245-901 |
| Register Number: | 000245901 |
| ZIP code: | 36104 |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Principal Address: | MONTGOMERY, AL |
| Registered Office Street Address: | 2 NORTH JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
| Authorized Capital: | $10 |
Activities
HOSPITAL/HEALTH CARE FACILITY
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | Centre Hospital Corporation, FLORIDA | F17000004452 | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447392535 | 2007-02-13 | 2011-12-16 | PO BOX 1547, SEDALIA, MO, 653021547, US | 400 NORTHWOOD DR, CENTRE, AL, 359601023, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 660-826-5960 |
| Fax | 6608264852 |
| Phone | +1 256-927-1300 |
Authorized person
| Name | DEBBIE BREWER |
| Role | DIRECTOR |
| Phone | 6154657000 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | RR MEDICARE |
| Number | DG4343 |
| State | AL |
| Issuer | MEDICAID |
| Number | 529932859 |
| State | AL |
| Name | Role |
|---|---|
| KECK, ROBIN J | Incorporator |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 6190 POWERS FERRY RD STE 600ATLANTA, GA 30339 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
