| Name: | Hoover Vision Center, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 24 Mar 2006 (19 years ago) |
| Entity Number: | 000-246-586 |
| Register Number: | 000246586 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | HOOVER, AL |
| Registered Office Street Address: | 2801 JOHN HAWKINS PKWY, STE 101AHOOVER, AL 35244 |
| Registered Office Street Address ZIP Code: | 35244 |
| Authorized Capital: | $1,000 |
Activities
OPTOMETRY PRACTICE
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ZZLLAS8EJ6U4 | 2024-10-02 | 2801 JOHN HAWKINS PKWY STE 101A, HOOVER, AL, 35244, 4021, USA | 2801 JOHN HAWKINS PKWY STE 101A, HOOVER, AL, 35244, 4021, USA | |||||||||||||||||||||||||||||||||||||||||
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| Division Name | HOOVER VISION CENTER |
| Congressional District | 06 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2023-10-04 |
| Initial Registration Date | 2023-10-03 |
| Entity Start Date | 2006-03-23 |
| Fiscal Year End Close Date | Dec 31 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | GLENDA KING |
| Role | BILLING & INSURANCE COORDINATOR |
| Address | 2801 JOHN HAWKINS PKWY, SUITE 101A, HOOVER, AL, 35244, 4021, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | GLENDA KING |
| Role | BILLING & INSURANCE COORDINATOR |
| Address | 2801 JOHN HAWKINS PKWY, SUITE 101A, HOOVER, AL, 35244, 4021, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073542965 | 2006-07-02 | 2008-05-10 | 2801 JOHN HAWKINS PKWY, SUITE 149 M, HOOVER, AL, 352444007, US | 2801 JOHN HAWKINS PKWY, SUITE 149 M, HOOVER, AL, 352444007, US | |||||||||||||||||||||||||||
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| Phone | +1 205-985-7640 |
| Fax | 2059857638 |
Authorized person
| Name | DR. ROBIN L MARBOURG |
| Role | OPTOMETRIST/OFFICER |
| Phone | 2059857640 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529928980 |
| State | AL |
| Issuer | BLOCK VISION |
| Number | 109180 |
| State | AL |
| Name | Role |
|---|---|
| MARBOURG, ROBIN L | Agent |
| Name | Role |
|---|---|
| SAMFORD, ABNOUS A | Incorporator |
| MARBOURG, ROBIN L | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
