| Name: | Andalusia Medical Center, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 27 Jul 2011 (13 years ago) (Companies founded in July 2011) |
| Entity Number: | 000-020-826 |
| Register Number: | 000020826 |
| Place of Formation: | Covington County |
| Registered Office Street Address: | 301 MEDICAL AVE STE AANDALUSIA, AL 35421 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831479781 | 2011-08-24 | 2014-12-29 | 1800 US HWY 84 WEST, OPP, AL, 364673520, US | 1800 US HWY 84 WEST, OPP, AL, 364673520, US | |||||||||||||||
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| Phone | +1 334-493-4357 |
| Fax | 3342223825 |
Authorized person
| Name | MR. KEVIN RAY DIEL |
| Role | M.D./OWNER |
| Phone | 3344934357 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DIEL, KEVIN R | Agent | 301 MEDICAL AVE STE AANDALUSIA, AL 36421 |
| Name | Role | Address |
|---|---|---|
| DIEL, KEVIN R | Organizer | 301 MEDICAL AVE STE AANDALUSIA, AL 36421 |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
