| Name: | Dothan Diagnostic Imaging, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 21 Aug 1997 (27 years ago) (Companies founded in August 1997) |
| Date of dissolution: | 12 Jun 2024 |
| Entity Number: | 000-189-783 |
| Register Number: | 000189783 |
| Historical Names: |
Dothan Diagnostic Imaging, Inc.
|
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Houston County |
| Principal Address: | 3480 PRESTON RIDGE ROAD SUITE 600ALPHARETTA, GA 30005 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
Activities
DIAGNOSTIC IMAGING CENTER
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972561686 | 2006-05-02 | 2008-05-15 | 3480 PRESTON RIDGE RD STE 600, CREDENTIALING DEPT, ALPHARETTA, GA, 300055462, US | 2240 W MAIN ST, DOTHAN, AL, 363011222, US | |||||||||||||||||||||||||||
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| Phone | +1 770-300-0101 |
| Fax | 7703000429 |
| Phone | +1 334-792-1525 |
| Fax | 3346711678 |
Authorized person
| Name | MR. DANIEL J SCHAEFER |
| Role | COO |
| Phone | 7703000101 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000051497 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
| Name | Role | Address |
|---|---|---|
| NORMARK, PER B | Organizer | 3480 PRESTON RIDGE ROAD SUITE 600ALPHARETTA, GA 30005 |
| SCHAEFER, DANIEL J | Organizer | 3480 PRESTON RIDGE ROAD SUITE 600ALPHARETTA, GA 30005 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2013-12-30 | Name Change | Dothan Diagnostic Imaging, Inc. | Dothan Diagnostic Imaging, LLC |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
