| Name: | Cardiac Institute of South Alabama, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 06 Jun 2013 (11 years ago) |
| Entity Number: | 000-280-979 |
| Register Number: | 000280979 |
| County: | Dallas |
| Place of Formation: | Dallas County |
| Registered Office Street Address: | 101 PARK PLACESELMA, AL 36701 |
| Registered Office Street Address ZIP Code: | 36701 |
Activities
PROVIDING MEDICAL SERVICES AND SALES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427499789 | 2013-07-15 | 2013-07-15 | 101 PARK PL, SELMA, AL, 367016764, US | 101 PARK PL, SELMA, AL, 367016764, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 334-526-2200 |
| Fax | 3345262220 |
Authorized person
| Name | MS. MASHAWN DENISE HUNTER |
| Role | OFFICE MANAGER |
| Phone | 3345262200 |
Taxonomy
| Taxonomy Code | 261QI0500X - Infusion Therapy Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QM2500X - Medical Specialty Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QP3300X - Pain Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| BUTT, SAMIRA | Agent | 101 PARK PLACESELMA, AL 36701 |
| Name | Role | Address |
|---|---|---|
| BUTT, SAMIRA | Organizer | 101 PARK PLACESELMA, AL 36701 |
| BUTT, AMJAD | Organizer | 101 PARK PLACESELMA, AL 36701 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
