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Eternity Hospice Inc

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Company Details

Name: Eternity Hospice Inc
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: InActive
Effective Date: 14 Oct 2004 (21 years ago)
Business ID: 862297
State of Incorporation: MISSISSIPPI

Agent

Name Role Address
Fairley, Charles Agent 11 Captain Fairley Rd;P O Box 6424, Laurel, MS 39441

Incorporator

Name Role Address
Charles Fairley Incorporator 11 Captain Fairley, Collins, MS 39428
Donald H Pugh Sr Incorporator P O Box 6424, Laurel, MS 39441

National Provider Identifier

NPI Number:
1467481101

Authorized Person:

Name:
CHARLES FAIRLEY
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
251G00000X - Community Based Hospice Care Agency
Is Primary:
Yes

Contacts:

Fax:
2288327213

Form 5500 Series

Employer Identification Number (EIN):
364546738
Plan Year:
2009
Number Of Participants:
23
Sponsors Telephone Number:

Filings

Type Status Filed Date Description
Dissolution Filed 2004-12-08 Dissolution
Formation Form Filed 2004-10-14 Formation

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Date of last update: 01 Jul 2025

Sources: Company Profile on Mississippi Secretary of State Website