| Name: | National Healthcare of Cullman, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Corporation |
| Status: | Merged |
| Entity Number: | 000-887-722 |
| Register Number: | 000887722 |
| ZIP code: | 36104 |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | 1209 ORANGE STWILMINGTON, DE 19801 |
| Registered Office Street Address: | 2 NORTH JACKSON ST., SUITE 605MONTGOMERY, AL 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124115696 | 2006-10-06 | 2009-06-23 | 501 CORPORATE CENTRE DR STE 200, FRANKLIN, TN, 370672662, US | 1910 CHEROKEE AVE SW, CULLMAN, AL, 35055, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 615-764-3009 |
| Fax | 6157643030 |
| Phone | +1 256-775-7400 |
| Fax | 2567758388 |
Authorized person
| Name | MR. S RAY COFFEY |
| Role | VP, REIMBURSEMENT |
| Phone | 6157643009 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | H2202 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1007144 |
| State | AL |
| Issuer | BCBS |
| Number | 51044121 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
