| Name: | JOHN C.SIMMONS,M.D.,L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 19 Oct 2011 (13 years ago) |
| Entity Number: | 000-027-808 |
| Register Number: | 000027808 |
| County: | Marengo |
| Place of Formation: | Marengo County |
| Registered Office Street Address: | 100 EAST CAHABA STREETLINDEN, AL 36748 |
| Registered Office Street Address ZIP Code: | 36748 |
Activities
TO OWN
LEASE
BUY
SELL
MANAGE
DEVELOP
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851614721 | 2010-03-08 | 2015-09-28 | PO BOX 480070, LINDEN, AL, 367480070, US | 100 E CAHABA AVE, LINDEN, AL, 367481204, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 334-295-0170 |
| Fax | 3342952275 |
Authorized person
| Name | DR. JOHN C SIMMONS |
| Role | PRESIDENT |
| Phone | 3342950170 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | 16795 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD AL |
| Number | 511-03472 |
| State | AL |
| Issuer | MEDICAID |
| Number | 117645 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| SIMMONS, JOHN C | Agent | 100 EAST CAHABA STREETLINDEN, AL 36748 |
| Name | Role | Address |
|---|---|---|
| SIMMONS, JOHN C | Organizer | 100 EAST CAHABA STREETLINDEN, AL 36748 |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
