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Physicians Choice Dialysis of Attalla, LLC

Details

Name: Physicians Choice Dialysis of Attalla, LLC
Jurisdiction: Alabama
Legal type: Foreign Limited Liability Company
Status: Withdrawn
Date of registration: 20 Feb 2012 (13 years ago) (Companies founded in February 2012)
Entity Number: 000-031-330
Register Number: 000031330
ZIP code: 36104 (Companies in Montgomery, 36104)
County: Montgomery
Place of Formation: Delaware
Principal Address: 211 COMMERCE COURT STE 104POTTSTOWN, PA 19464
Registered Office Street Address: 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1992065650 2012-05-29 2015-02-06 211 COMMERCE CT, SUITE 104, POTTSTOWN, PA, 194643483, US 801 GILBERT FERRY RD SE, ATTALLA, AL, 359543362, US

Contacts

Phone +1 610-495-8900
Fax 6104958560
Phone +1 256-691-0766
Fax 2566910789

Authorized person

Name KELLY SMITH
Role DIRECTOR OF LEGAL/HR
Phone 6104958900

Taxonomy

Taxonomy Code 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center
State AL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 146338
State AL

Agent

Name Role Address
CORPORATION SERVICE COMPANY INC Agent 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State