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Wiregrass Wound Care Consultants LLC

Details

Name: Wiregrass Wound Care Consultants LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 09 Oct 2013 (11 years ago) (Companies founded in October 2013)
Entity Number: 000-288-935
Register Number: 000288935
ZIP code: 36310 (Companies in Henry, 36310)
County: Henry
Place of Formation: Henry County
Registered Office Street Address: 1833 COUNTY ROAD 133ABBEVILLE, AL 36310

Activities MEDICAL SERVICES & ALL LAWFUL BUSINESS

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1003245838 2013-11-02 2013-12-09 725 N HIGHWAY A1A, SUITE C112-113, JUPITER, FL, 334774571, US 1908 FAIRVIEW AVE, DOTHAN, AL, 363013008, US

Contacts

Phone +1 561-578-8407
Fax 5615788099
Phone +1 251-295-2815
Fax 2512952815

Authorized person

Name DR. JEFFREY HERBERT FADIL
Role PHYSICIAN
Phone 2512952815

Taxonomy

Taxonomy Code 207R00000X - Internal Medicine Physician
License Number 29664
State AL
Is Primary Yes

Agent

Name Role
FADIL, JEFFREY H Agent

Organizer

Name Role Address
FADIL, JEFFREY H Organizer No data
LUMBATIS, ALLISON REID Organizer 360 NORTH OATES STREETDOTHAN, AL 36303

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State