| Name: | Mobile Medical and Diagnostic Center, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 21 Mar 1989 (36 years ago) |
| Date of dissolution: | 15 Nov 2019 |
| Entity Number: | 000-129-736 |
| Register Number: | 000129736 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Principal Address: | MOBILE, AL |
| Registered Office Street Address: | 2261 COSTARIDES STREETMOBILE, AL 36617 |
| Registered Office Street Address ZIP Code: | 36617 |
| Authorized Capital: | 100 NPV |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518188457 | 2007-05-01 | 2010-03-03 | 2261 COSTARIDES ST, MOBILE, AL, 366172443, US | 2261 COSTARIDES ST, MOBILE, AL, 366172443, US | |||||||||||||||||||||||||
|
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| Phone | +1 251-471-4402 |
| Fax | 2514714496 |
Authorized person
| Name | DR. RAYMOND L. BELL |
| Role | OWNER |
| Phone | 2514714402 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | 8377 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529301820 |
| State | AL |
| Name | Role |
|---|---|
| BELL, RAYMOND LLOYD MD | Agent |
| Name | Role |
|---|---|
| BELL, RAYMOND LLOYD MD | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
