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Curecanti Dialysis, LLC

Details

Name: Curecanti Dialysis, LLC
Jurisdiction: Alabama
Legal type: Foreign Limited Liability Company
Status: Exists
Date of registration: 18 Jul 2012 (12 years ago)
Entity Number: 000-039-647
Register Number: 000039647
County: Montgomery
Place of Formation: Delaware
Principal Address: 1551 WEWATTA STREETDENVER, CO 80202
Principal Mailing Address: 601 HAWAII STREETEL SEGUNDO, CA 90245
Registered Office Street Address: 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104
Registered Office Street Address ZIP Code: 36104

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1588096911 2013-08-08 2024-05-08 5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN, 370277569, US 1763 E MAIN ST, DOTHAN, AL, 363013045, US

Contacts

Phone +1 334-673-0246
Fax 3346730328

Authorized person

Name SAMUEL T. WEY
Role VP, LICENSURE & CERTIFICATION
Phone 6153416641

Taxonomy

Taxonomy Code 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number S3504
State AL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 1588096911
State AL

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
71WB7 Active Non-Manufacturer 2014-02-06 2024-02-23 2028-02-27 2024-02-23

Contact Information

POC DONNA BRAWLEY
Phone +1 253-382-1294
Fax +1 888-577-9570
Address 1763 EAST MAIN ST, DOTHAN, AL, 36301 3045, UNITED STATES

Ownership of Offeror Information

Highest Level Owner Information not Available
Immediate Level Owner
Vendor Certified 2023-02-27
CAGE number 45JM2
Company Name DAVITA INC.
CAGE Last Updated 2024-03-29
List of Offerors (0) Information not Available

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