| Name: | AseraCare Hospice - Monroeville, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 24 May 2004 (21 years ago) |
| Entity Number: | 000-606-752 |
| Register Number: | 000606752 |
| ZIP code: | 36104 |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | ONE THOUSAND BEVERLY WAYFORT SMITH, AR 72919 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
Activities
HOSPICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992742431 | 2006-06-01 | 2020-07-06 | 3854 AMERICAN WAY STE A, BATON ROUGE, LA, 708164897, US | 1201 MONTLIMAR DR STE 100, MOBILE, AL, 366091718, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 225-292-2031 |
| Fax | 2252959678 |
| Phone | +1 251-303-8574 |
| Fax | 2513038574 |
Authorized person
| Name | PAUL KUSSEROW |
| Role | PRESIDENT |
| Phone | 2252922031 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| License Number | 200812171016 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 012-473 |
| Issuer | MEDICAID |
| Number | PIC-1567E |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
