| Name: | ABC Orthotics & Prosthetics Cullman LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 20 Mar 2013 (12 years ago) |
| Entity Number: | 000-276-128 |
| Register Number: | 000276128 |
| County: | Cullman |
| Place of Formation: | Cullman County |
| Principal Address: | 501 MAIN AVE SWCULLMAN, AL 35055 |
| Principal Address ZIP Code: | 35055 |
| Registered Office Street Address: | 108 CLOVERLEAF DRIVEATHENS, AL 35611 |
| Registered Office Street Address ZIP Code: | 35611 |
Activities
FABRICATION/SALES OF ORTHOTIC AND PROSTHETIC DEVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134438898 | 2010-09-29 | 2013-11-07 | 501 MAIN AVE SW, CULLMAN, AL, 350554728, US | 501 MAIN AVE SW, CULLMAN, AL, 350554728, US | |||||||||||||||||||||||||||
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| Phone | +1 256-775-6041 |
| Fax | 2567756052 |
| Fax | 2567756058 |
Authorized person
| Name | ALEISHA MULLINS HARVEY |
| Role | MANAGER |
| Phone | 2567756041 |
Taxonomy
| Taxonomy Code | 335E00000X - Prosthetic/Orthotic Supplier |
| License Number | 15827 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000052115 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| BERRYHILL, JONATHAN | Agent | 1740 MERRYVALE ROADVESTAVIA HILLS, AL 35216 |
| Name | Role | Address |
|---|---|---|
| MULLINS, STEPHEN DWAYNE | Organizer | 283 MAGNOLIA TRACE ROADCRANE HILL, AL 35053 |
| HARVEY, ALEISHA MULLINS | Organizer | 283 MAGNOLIA TRACE ROADCRANE HILL, AL 35053 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
