| Name: | Prattville Christian Family Medicine, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 20 Nov 2013 (11 years ago) |
| Entity Number: | 000-291-782 |
| Register Number: | 000291782 |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Principal Address: | 128 MITYLENE PARK LANEMONTGOMERY, AL 36117 |
| Principal Address ZIP Code: | 36117 |
Activities
HEALTHCARE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649696196 | 2014-03-07 | 2014-03-12 | 128 MITYLENE PARK LN, MONTGOMERY, AL, 361173758, US | 478 MCQUEEN SMITH RD S, PRATTVILLE, AL, 360665631, US | |||||||||||||||||||||||
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| Phone | +1 334-279-8180 |
| Fax | 3342798214 |
| Phone | +1 334-356-9200 |
| Fax | 3343561064 |
Authorized person
| Name | ASHLEY MCINTYRE |
| Role | OWNER |
| Phone | 3342798180 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 00025985 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MCINTYRE, ASHLEY | Agent | 2126 SIXTH AVE SE SUITE 201DECATUR, AL 35601 |
| Name | Role | Address |
|---|---|---|
| MCINTYRE, ASHLEY D | Organizer | 129 MITYLENE PARK LANEMONTGOMERY, AL 36117 |
| PRATTVILLE CHRISTIAN FAMILY MEDICINE LLC | Organizer | 128 MITYLENE PARK LANEMONTGOMERY, AL 36117 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
