| Name: | IMC-Eastern Shore Adult Medicine, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 29 Sep 2011 (13 years ago) |
| Entity Number: | 000-026-433 |
| Register Number: | 000026433 |
| Historical Names: |
IMC-Eastern Shore Adult Medicine, P.C.
|
| County: | Mobile |
| Place of Formation: | Mobile County |
| Registered Office Street Address: | 5 MOBILE INFIRMARY CIRCLEMOBILE, AL 36607 |
| Registered Office Street Address ZIP Code: | 36607 |
| Principal Address: | 1700 SPRINGHILL AVENUEMOBILE, AL 36604 |
| Principal Address ZIP Code: | 36604 |
| Principal Mailing Address: | PO BOX 2226MOBILE, AL 36652 |
| Principal Mailing Address ZIP Code: | 36652 |
Activities
TO RENDER PROFESSIONAL MEDICAL SVCS & SERVICES ANCILLARY THERETO
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912284852 | 2011-11-07 | 2019-11-01 | 300 GREENO RD S, SUITE B, FAIRHOPE, AL, 365321905, US | 300 GREENO RD S, SUITE B, FAIRHOPE, AL, 365321905, US | |||||||||||||||||||
|
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| Phone | +1 251-929-3424 |
| Fax | 2519293430 |
Authorized person
| Name | ANTHONY PALAZZO |
| Role | VICE PRESIDENT OF FINANCE |
| Phone | 2514351361 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| Is Primary | No |
| Name | Role |
|---|---|
| NIX, D M | Agent |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2017-03-24 | Name Change | IMC-Eastern Shore Adult Medicine, P.C. | IMC-Eastern Shore Adult Medicine, LLC |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
