| Name: | Synergy Medical, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 08 Nov 2012 (12 years ago) |
| Entity Number: | 000-278-350 |
| Register Number: | 000278350 |
| County: | Mobile |
| Place of Formation: | South Carolina |
| Principal Address: | 110 N RANDOLPH AVELANDRUM, SC 29356 |
| Registered Office Street Address: | 2868 DOG RIVER ROADTHEODORE, AL 36582 |
| Registered Office Street Address ZIP Code: | 36582 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881035418 | 2013-07-11 | 2013-08-05 | 110 N RANDOLPH AVE, LANDRUM, SC, 293561512, US | 831 1ST ST N, ALABASTER, AL, 350078944, US | |||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 864-457-2222 |
| Fax | 8644572269 |
| Phone | +1 205-358-9120 |
Authorized person
| Name | ARTHUR W ROBBINS |
| Role | OWNER |
| Phone | 8644572222 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 13549 |
| State | SC |
| Is Primary | Yes |
| Taxonomy Code | 335E00000X - Prosthetic/Orthotic Supplier |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | DE3416 |
| State | SC |
| Issuer | BCBS OF SC |
| Number | 1093952731 |
| State | SC |
| Issuer | MEDICAID |
| Number | 7705390 |
| State | NC |
| Name | Role | Address |
|---|---|---|
| PITTS, BRAD | Agent | 5570 RANGELINE ROADMOBILE, AL 36619 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
