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JOHN C.SIMMONS,M.D.,L.L.C.

Details

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) (Companies founded in October 2011)
Entity Number: 000-027-808
Register Number: 000027808
ZIP code: 36748 (Companies in Marengo, 36748)
County: Marengo
Place of Formation: Marengo County
Registered Office Street Address: 100 EAST CAHABA STREETLINDEN, AL 36748

Activities TO OWN
LEASE
BUY
SELL
MANAGE
DEVELOP

National Provider Identifier

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

Contacts

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

Agent

Name Role Address
SIMMONS, JOHN C Agent 100 EAST CAHABA STREETLINDEN, AL 36748

Organizer

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