| Name: | Physicians Choice Dialysis of Union Springs, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Withdrawn |
| Date of registration: | 20 Oct 2010 (14 years ago) (Companies founded in October 2010) |
| Entity Number: | 000-003-038 |
| Register Number: | 000003038 |
| 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 | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336433556 | 2011-06-06 | 2015-02-06 | 211 COMMERCE CT, SUITE 104, POTTSTOWN, PA, 194643483, US | 112 CONECUH WEST AVENUE, UNION SPRINGS, AL, 360891303, US | |||||||||||||||||||||||||||||
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| Phone | +1 610-495-8900 |
| Fax | 6104958560 |
Authorized person
| Name | 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 | BCBS OF AL |
| Number | 013-576 |
| State | AL |
| Issuer | MEDICAID |
| Number | 135143 |
| 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
