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Physicians Choice Dialysis of Lee County, LLC

Details

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Status: Withdrawn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

National Provider Identifier

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

Contacts

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

Agent

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