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Mid-Delta Hospice South, Inc.

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Company Details

Name: Mid-Delta Hospice South, Inc.
Jurisdiction: MISSISSIPPI
Business Type: Profit Corporation
Status: Good Standing
Effective Date: 10 Jan 2005 (21 years ago)
Business ID: 866039
ZIP code: 39038
County: Humphreys
State of Incorporation: MISSISSIPPI
Principal Office Address: 405 N HAYDEN STBELZONI, MS 39038
Fictitious names: Bristol Hospice - Brookhaven
Historical names: Mid-Delta Hospice of Canton, Inc.

Agent

Name Role Address
REGISTERED AGENT SOLUTIONS, INC Agent 8927 Lorraine Rd., Ste. 204-A, Gulfport, MS 39503

Incorporator

Name Role Address
Paul Mathis Jr Incorporator 540 Main Street Ste 300, Greenville, MS 38701

Secretary

Name Role Address
John Garbarino Secretary 1000 Winter Street, Waltham, MA 02451

Treasurer

Name Role Address
John Garbarino Treasurer 1000 Winter Street, Waltham, MA 02451

Vice President

Name Role Address
David Malm Vice President 1000 Winter Street, Waltham, MA 02451

Chief Financial Officer

Name Role Address
Michael Derrick Chief Financial Officer 206 N 2100 W, STE 202, SALT LAKE CITY, UT 84116

President

Name Role Address
Alex Mauricio President 206 N 2100 W, STE 202, SALT LAKE CITY, UT 84116

Chief Executive Officer

Name Role Address
Alex Mauricio Chief Executive Officer 206 N 2100 W, STE 202, SALT LAKE CITY, UT 84116

Director

Name Role Address
Bridget Dunn Director 711 Brookway Blvd, Ste B, Brookhaven, MS 39601

National Provider Identifier

NPI Number:
1316900962
Certification Date:
2024-07-02

Authorized Person:

Name:
ALEX MAURICIO
Role:
PRESIDENT/CEO
Phone:

Taxonomy:

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

Contacts:

Fax:
6622474924

Filings

Type Status Filed Date Description
Annual Report Filed 2025-02-20 Annual Report For Mid-Delta Hospice South, Inc.
Fictitious Name Registration Filed 2024-06-21 Fictitious Name Registration For Mid-Delta Hospice South, Inc.
Amendment Form Filed 2024-06-21 Amendment For Mid-Delta Hospice South, Inc.
Annual Report Filed 2024-04-15 Annual Report For Mid-Delta Hospice South, Inc.
Annual Report Filed 2023-04-17 Annual Report For Mid-Delta Hospice South, Inc.
Annual Report Filed 2022-04-18 Annual Report For Mid-Delta Hospice South, Inc.
Annual Report Filed 2021-04-16 Annual Report For Mid-Delta Hospice South, Inc.
Amendment Form Filed 2021-01-19 Amendment For Mid-Delta Hospice of Canton, Inc.
Annual Report Filed 2020-04-14 Annual Report For Mid-Delta Hospice of Canton, Inc.
Annual Report Filed 2019-05-15 Annual Report For Mid-Delta Hospice of Canton, Inc.

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Date of last update: 01 Jul 2025

Sources: Company Profile on Mississippi Secretary of State Website