Public record

CMS Hospice All Owners

Associate id: 1456260868 · 22 matching records

Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
0749213171
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2020-01-27
First name - owner
KEVIN
Last name - owner
DILALLO
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
0840452108
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2020-01-27
First name - owner
KAREN
Last name - owner
FORDHAM
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
1254389950
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2020-01-27
First name - owner
JAMES
Middle name - owner
V
Last name - owner
FIORICA
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
1456615509
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2016-09-01
First name - owner
AMANDA
Middle name - owner
J
Last name - owner
MCCRORY
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
1456696939
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2018-10-01
First name - owner
JONATHAN
Middle name - owner
D
Last name - owner
FLEECE
Title - owner
PRESIDENT AND CEO
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
1456696939
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2018-10-01
First name - owner
JONATHAN
Middle name - owner
D
Last name - owner
FLEECE
Title - owner
PRESIDENT AND CEO
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
1557625605
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2016-01-01
First name - owner
RENEE
Middle name - owner
W
Last name - owner
EPPARD
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
2163897497
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2023-01-11
First name - owner
CHRISTY
Last name - owner
HENDRICKS
Title - owner
GENERAL COUNSEL & CHIEF LEGAL OFFIC
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
2466716519
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2016-09-01
First name - owner
STEPHEN
Middle name - owner
W
Last name - owner
HALL
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
3375712110
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2011-01-01
First name - owner
SAIDA
Last name - owner
BOUHAMID
Title - owner
CHIEF FINANCIAL OFFICER
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
3779912274
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2020-01-27
First name - owner
MATT
Last name - owner
MAYPER
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
4688003189
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2020-01-27
First name - owner
MELINDA
Last name - owner
RYALS
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
5193089241
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2016-09-01
First name - owner
KEVIN
Middle name - owner
P
Last name - owner
LOGAN
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
5597194092
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2020-01-27
First name - owner
FERMIN
Last name - owner
MIRANDA
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
6103180252
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2016-11-01
First name - owner
KIMBERLIE
Middle name - owner
A
Last name - owner
BUCHANAN
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
8325202005
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2016-06-07
First name - owner
STEVEN
Last name - owner
ROSKAMP
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
8426310731
Type - owner
O
Role code - owner
34
Role text - owner
5% OR GREATER DIRECT OWNERSHIP INTEREST
Association date - owner
2016-06-07
Organization name - owner
STRATUM HEALTH SYSTEM
Address line 1 - owner
5955 RAND BLVD
City - owner
SARASOTA
State - owner
FL
Zip code - owner
342385160
Percentage ownership
100
Created for acquisition - owner
N
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
Y
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
8426310731
Type - owner
O
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2016-06-07
Organization name - owner
STRATUM HEALTH SYSTEM
Address line 1 - owner
5955 RAND BLVD
City - owner
SARASOTA
State - owner
FL
Zip code - owner
342385160
Percentage ownership
100
Corporation - owner
N
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
Y
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
8527147370
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2018-01-01
First name - owner
JANICE
Last name - owner
MILLER
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
8628332772
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2016-03-01
First name - owner
JACOB
Middle name - owner
P
Last name - owner
SORG
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
8628383262
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2020-01-27
First name - owner
RANDAL
Last name - owner
CURRIN JR.
Title - owner
BOARD MEMBER
Percentage ownership
0
Enrollment id
O20051219000111
Associate id
1456260868
Organization name
TIDEWELL HOSPICE, INC.
Associate id - owner
9830506096
Type - owner
O
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2021-03-01
Organization name - owner
EMPATH-STRATUM INC
Doing business as name - owner
EMPATH HEALTH
Address line 1 - owner
5955 RAND BLVD
City - owner
SARASOTA
State - owner
FL
Zip code - owner
342385160
Percentage ownership
100
Corporation - owner
Y
Llc - owner
N
Medical provider supplier - owner
N
Management services company - owner
N
Medical staffing company - owner
N
Holding company - owner
N
Investment firm - owner
N
Financial institution - owner
N
Consulting firm - owner
N
For profit - owner
N
Non profit - owner
Y
Private equity company - owner
N
Reit - owner
N
Chain home office - owner
N
Other type - owner
N

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