| Name: | Primary Care and Pain Management Clinic, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 26 Feb 2013 (12 years ago) |
| Entity Number: | 000-274-550 |
| Register Number: | 000274550 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 5415 BEACON DRIVEBIRMINGHAM, AL 35210 |
| Registered Office Street Address ZIP Code: | 35210 |
Activities
PRIMARY CARE
INTERNAL MEDICINE
MEDICAL REVIEW SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215328497 | 2015-02-10 | 2015-02-10 | 5415 BEACON DR, SUITE 163, IRONDALE, AL, 352102860, US | 5415 BEACON DR, SUITE 163, IRONDALE, AL, 352102860, US | |||||||||||||||
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| Phone | +1 205-956-8767 |
Authorized person
| Name | MILA VELUZ |
| Role | REGISTERED NURSE |
| Phone | 2059568767 |
Taxonomy
| Taxonomy Code | 261QP3300X - Pain Clinic/Center |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| VELUZ, MILAGROS M | Organizer | 412 KIRKLAND ACIRCLECHILDERSBURG, AL 35044 |
| VELUZ, MILA M | Organizer | 5415 BEACON DRIVEBIRMINGHAM, AL 35210 |
| Name | Role | Address |
|---|---|---|
| VELUZ, MILA M | Agent | 5415 BEACON DRIVEBIRMINGHAM, AL 35210 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
