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GMUC OF CITRONELLE, LLC.

Details

Name: GMUC OF CITRONELLE, LLC.
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 30 Jan 2012 (13 years ago) (Companies founded in January 2012)
Entity Number: 000-039-273
Register Number: 000039273
ZIP code: 36695 (Companies in Mobile, 36695)
County: Mobile
Place of Formation: Mobile County
Registered Office Street Address: 2350 SCHILLINGER ROAD SUITE AMOBILE, AL 36695

Activities DEAL IN/WITH MEDICAL SERVICES OF ALL KINDS

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1164794343 2012-02-02 2023-08-02 7943 MOFFETT RD, SEMMES, AL, 365755409, US 19355 N 3RD ST, SUITE 104, CITRONELLE, AL, 365222049, US

Contacts

Phone +1 251-633-0123
Fax 2514453722

Authorized person

Name DARREN K WATERS
Role MEDICAL DIRECTOR
Phone 2516330123

Taxonomy

Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes
Taxonomy Code 261QU0200X - Urgent Care Clinic/Center
Is Primary No

Organizer

Name Role Address
ROUSE, ROBERT H Organizer 2000 LACLEDE BUILDING, 150 GOVERNMENMOBILE, AL 36602-3935
WATERS, DARREN K Organizer 2350 SCHILLINGER ROAD S SUITE AMOBILE, AL 36695

Agent

Name Role Address
WATERS, DARREN K Agent 2350 SCHILLINGER ROAD S SUITE AMOBILE, AL 36695

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State