| Name: | HIGHLANDS FAMILY MEDICINE, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 21 Mar 2012 (13 years ago) |
| Entity Number: | 000-046-829 |
| Register Number: | 000046829 |
| County: | Jackson |
| Place of Formation: | Jackson County |
| Principal Address: | 507 HARLEY STREETSCOTTSBORO, AL 35768 |
| Principal Address ZIP Code: | 35768 |
| Registered Office Street Address: | 126 E PEACHTREE STREETSCOTTSBORO, AL 35768 |
| Registered Office Street Address ZIP Code: | 35768 |
Activities
PERFORM MEDICAL TREATMENT AND ALL INCIDENTS RELATED THERETO
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013273119 | 2012-04-03 | 2022-03-22 | PO BOX 1050, SCOTTSBORO, AL, 357681050, US | 507 HARLEY ST, SCOTTSBORO, AL, 357684218, US | |||||||||||||||||||||
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| Phone | +1 256-259-0061 |
| Fax | 2562590668 |
| Phone | +1 256-218-3856 |
| Fax | 2562183536 |
Authorized person
| Name | KAREN GRIDER |
| Role | DIRECTOR OF PHYSICIAN SERVICES |
| Phone | 2562183856 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| LACKEY, GARY W | Agent |
| Name | Role | Address |
|---|---|---|
| BRYANT, KIM | Organizer | 75 14TH STREET SUITE 2710ATLANTA, GA 30309 |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
