| Name: | Horizon Healthcare LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 02 Aug 2012 (12 years ago) |
| Entity Number: | 000-072-598 |
| Register Number: | 000072598 |
| County: | De Kalb |
| Place of Formation: | Jackson County |
| Principal Address: | 126 COMMERCE AVENUEVALLEY HEAD, AL 35989 |
| Principal Address ZIP Code: | 35989 |
| Principal Mailing Address: | PO BOX 243VALLEY HEAD, AL 35989 |
| Principal Mailing Address ZIP Code: | 35989 |
Activities
PHYSICIAN
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| YFNQJP27E6N4 | 2022-07-14 | 205 GRAND AVE NW, FORT PAYNE, AL, 35967, 2107, USA | HORIZON HEALTHCARE, FORT PAYNE, AL, 35967, 2107, USA | |||||||||||||||||||||||||||||||||||||||
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| Division Name | HORIZON HEALTHCARE LLC |
| Division Number | HORIZON HE |
| Congressional District | 04 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2021-06-22 |
| Initial Registration Date | 2021-06-14 |
| Entity Start Date | 2012-08-02 |
| Fiscal Year End Close Date | Dec 31 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | MUHAMMAD E ATA |
| Address | 205 GRAND AVE NW, FORT PAYNE, AL, 35967, 2107, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | MUHAMMAD E ATA |
| Address | 205 GRAND AVE NW, FORT PAYNE, AL, 35967, 2107, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952659419 | 2012-08-15 | 2021-02-25 | 205 GRAND AVE NW STE A, FORT PAYNE, AL, 359672107, US | 205 GRAND AVE NW STE A, FORT PAYNE, AL, 359672107, US | |||||||||||||||||||||||||
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| Phone | +1 256-635-6600 |
| Fax | 2566356601 |
Authorized person
| Name | DR. MUHAMMAD EJAZ ATA |
| Role | OWNER |
| Phone | 2566356600 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | 16386 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE ID |
| Number | 01-8902 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| ATA, MUHAMMAD E | Organizer | 506 HARLEY STREETSCOTTSBORO, AL 35768 |
| Name | Role | Address |
|---|---|---|
| ATA, MUHAMMAD E | Agent | 506 HARLEY STREETSCOTTSBORO, AL 35768 |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
