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 | |||||||||||||||||||||||||||
|
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