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ABC Orthotics & Prosthetics Cullman LLC

Details

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) (Companies founded in March 2013)
Entity Number: 000-276-128
Register Number: 000276128
ZIP code: 35055 (Companies in Cullman, 35055)
County: Cullman
Place of Formation: Cullman County
Principal Address: 501 MAIN AVE SWCULLMAN, AL 35055
Registered Office Street Address: 108 CLOVERLEAF DRIVEATHENS, AL 35611

Activities FABRICATION/SALES OF ORTHOTIC AND PROSTHETIC DEVICES

National Provider Identifier

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

Contacts

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

Agent

Name Role Address
BERRYHILL, JONATHAN Agent 1740 MERRYVALE ROADVESTAVIA HILLS, AL 35216

Organizer

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