| Name: | Crisis Hospitalist Staffing Solutions, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 09 Apr 2012 (13 years ago) |
| Entity Number: | 000-050-303 |
| Register Number: | 000050303 |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Registered Office Street Address: | 82 PLANTATION PT #300FAIRHOPE, AL 36532 |
| Registered Office Street Address ZIP Code: | 36532 |
Activities
PHYSICIAN SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346507183 | 2012-04-18 | 2012-07-05 | 82 PLANTATION POINTE # 300, FAIRHOPE, AL, 365322962, US | 750 MORPHY AVE, FAIRHOPE, AL, 365321812, US | |||||||||||||||||||||||||||||
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| Phone | +1 251-988-1117 |
Authorized person
| Name | NICOLE VANNOR KERSH |
| Role | OWNER |
| Phone | 2519881117 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | 30174 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 137976 |
| State | AL |
| Issuer | BLUE CROSS |
| Number | 51125157 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| KERSH, NICOLE V | Agent | 10 NORTH SECTION STREET #162FAIRHOPE, AL 36532 |
| Name | Role | Address |
|---|---|---|
| LEGALZOOM.COM, INC. | Organizer | 101 N Brand Blvd., 11th FloorGlendale, CA 91203 |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
