Name: | Physicians Choice Dialysis of Lee County, LLC |
Jurisdiction: | Alabama |
Legal type: | Foreign Limited Liability Company |
Status: | Withdrawn |
Date of registration: | 18 Jan 2011 (14 years ago) (Companies founded in January 2011) |
Entity Number: | 000-001-888 |
Register Number: | 000001888 |
ZIP code: | 36104 (Companies in Montgomery, 36104) |
County: | Montgomery |
Place of Formation: | Delaware |
Principal Address: | 211 COMMERCE COURT STE 104POTTSTOWN, PA 19464 |
Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
Activities
DIALYSIS SERVICES
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1699058552 | 2011-09-27 | 2015-02-06 | 211 COMMERCE CT, SUITE 104, POTTSTOWN, PA, 194643483, US | 5009 RIVER CHASE DRIVE, BUILDING 300, PHENIX CITY, AL, 368677484, US | |||||||||||||||||||||||
|
Phone | +1 610-495-8900 |
Fax | 6104958560 |
Authorized person
Name | MRS. KELLY SMITH |
Role | DIRECTOR OF LEGAL |
Phone | 6104958900 |
Taxonomy
Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
State | AL |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 138523 |
State | AL |
Name | Role | Address |
---|---|---|
CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
Date of last update: 29 Jul 2024
Sources: Alabama Secretary of State