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Talladega Family Health Center LLC

Details

Name: Talladega Family Health Center LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 03 Mar 2011 (14 years ago)
Entity Number: 000-004-905
Register Number: 000004905
County: Talladega
Place of Formation: Talladega County
Registered Office Street Address: 300 MEDICAL OFFICE PARKTALLADEGA, AL 35160
Registered Office Street Address ZIP Code: 35160

Activities NOT PROVIDED

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1467741744 2011-04-07 2015-12-04 108 SANDERS ST, ATHENS, AL, 356112459, US 108 SANDERS ST, ATHENS, AL, 356112459, US

Contacts

Phone +1 256-230-1116
Fax 2562301156

Authorized person

Name DR. GEORGE ROBERT STOREY SR.
Role MANAGER
Phone 2562301116

Taxonomy

Taxonomy Code 261QH0100X - Health Service Clinic/Center
License Number 15022
State AL
Is Primary Yes

Agent

Name Role
STOREY, G R Agent

Organizer

Name Role Address
STOREY, G ROBERT Organizer 1113 SOUTHWOOD AVENUETALLADEGA, AL 35160

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State