SHOALS AMBULANCE, LLC

Details

Name:	SHOALS AMBULANCE, LLC
Jurisdiction:	Alabama
Legal type:	Domestic Limited Liability Company
Status:	Exists
Date of registration:	06 Feb 2012 (13 years ago)
Entity Number:	000-027-593
Register Number:	000027593
Historical Names:	SHOALS AMBULANCE,INC.
County:	Jefferson
Place of Formation:	Lauderdale County
Principal Mailing Address:	8501 E PRINCESS DRIVE, STE 195SCOTTSDALE, AZ 85255
Registered Office Street Address:	2 NORTH JACKSON STREET SUITE 605MONTGOMERY, AL 36104
Registered Office Street Address ZIP Code:	36104
Principal Address:	1826 3RD AVENUE N, SUITE 307BESSEMER, AL 35020
Principal Address ZIP Code:	35020

Activities TO OWN
OPERATE
MANAGE
AND GENERALLY TO CONDUCT ANY BUSINESS

Unique Entity ID

Expiration Date

Physical Address

Mailing Address

PSQMB293ATK5

2024-11-26

1826 3RD AVE N STE 307, BESSEMER, AL, 35020, 4900, USA

5251 S EAST STREET, SUITE 5, INDIANAPOLIS, IN, 46227, USA

Business Information

Division Name	SEALS AMBULANCE SERVICE, INC
Congressional District	07
State/Country of Incorporation	AL, USA
Activation Date	2023-11-30
Initial Registration Date	2023-11-27
Entity Start Date	2014-04-01
Fiscal Year End Close Date	Dec 31

Service Classifications

NAICS Codes	621910
Product and Service Codes	V225

Points of Contacts

Electronic Business
Title	PRIMARY POC
Name	ROBERT JEWELL
Role	CHIEF REVENUE INTEGRATION OFFICER
Address	1826 3RD AVE N SUITE 307, BESSEMER, AL, 35020, USA

Title	ALTERNATE POC
Name	BOB JEWELL
Role	CHIEF REVENUE INTEGRATION OFFICER
Address	1826 3RD AVE N SUITE 307, BESSEMER, AL, 35020, USA

Government Business
Title	PRIMARY POC
Name	ROBERT JEWELL
Role	CHIEF REVENUE INTEGRATION OFFICER
Address	1826 3RD AVE N SUITE 307, BESSEMER, AL, 35020, USA

Title	ALTERNATE POC
Name	BOB JEWELL
Role	CHIEF REVENUE INTEGRATION OFFICER
Address	1826 3RD AVE N SUITE 307, BESSEMER, AL, 35020, USA

Past Performance
Title	PRIMARY POC
Name	BOB JEWELL
Role	CHIEF REVENUE INTEGRATION OFFICER
Address	1826 3RD AVE N SUITE 307, BESSEMER, AL, 35020, USA

Title	ALTERNATE POC
Name	NETALENE MAHARAJ
Address	5251 S. EAST ST, SUITE 5, INDIANAPOLIS, IN, 46227, USA

National Provider Identifier

NPI

Enumeration Date

Last Update Date

Mailing Address

Practice Location Address

1497177695

2014-01-08

2016-04-27

5251 S EAST ST, SUITE 5, INDIANAPOLIS, IN, 462272038, US

310 E DR HICKS BLVD, FLORENCE, AL, 356305770, US

Contacts

Phone	+1 844-597-4911
Phone	+1 256-275-3342

Authorized person

Name	MR. MICKEUL B GIBSON
Role	CEO
Phone	8445974911

Taxonomy

Taxonomy Code	3416L0300X - Land Ambulance
State	TN
Is Primary	Yes

Agent

Name	Role	Address
CT CORPORATION SYSTEM	Agent	6190 POWERS FERRY RD STE 600ATLANTA, GA 30339

Organizer

Name	Role	Address
GIBSON, BRYAN	Organizer	7610 E SOARING EAGLE WAYSCOTTSDALE, AZ 85266
PITTS, CONRAD C	Organizer	401 EAST TUSCALOOSA STFLORENCE, AL 35630

Events

Event Date	Event Type	Old Value	New Value
2013-12-18	Name Change	SHOALS AMBULANCE,INC.	SHOALS AMBULANCE, LLC

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State