| Name: | IMC-Obstetrics and Gynecology Associates, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 14 Dec 1995 (29 years ago) (Companies founded in December 1995) |
| Date of dissolution: | 03 Nov 2020 |
| Entity Number: | 000-176-127 |
| Register Number: | 000176127 |
| Historical Names: |
IMC-Obstetrics and Gynecology Associates, P.C.
|
| ZIP code: | 36604 (Companies in Mobile, 36604) |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Registered Office Street Address: | 5 MOBILE INFIRMARY CIRCLEMOBILE, AL 36607 |
| Principal Address: | 1700 SPRINGHILL AVENUEMOBILE, AL 36604 |
| Principal Mailing Address: | PO BOX 2226MOBILE, AL 36652 |
Activities
TO RENDER PROFESSIONAL MEDICAL SVCS & SERVICES ANCILLARY THERETO
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932219847 | 2006-08-30 | 2008-07-28 | 3 MOBILE INFIRMARY CIR, SUITE 401, MOBILE, AL, 366073520, US | 3 MOBILE INFIRMARY CIR, SUITE 401, MOBILE, AL, 366073520, US | |||||||||||||||||||||
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| Phone | +1 251-435-7800 |
| Fax | 2514357801 |
Authorized person
| Name | MR. R BARRE SANDERS |
| Role | CLINIC ADMINISTRATOR |
| Phone | 2514357800 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529602720 |
| State | AL |
| Name | Role |
|---|---|
| NIX, D M | Agent |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2017-03-24 | Name Change | IMC-Obstetrics and Gynecology Associates, P.C. | IMC-Obstetrics and Gynecology Associates, LLC |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
