| Name: | Shoals Health Group, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 21 Jun 2012 (12 years ago) (Companies founded in June 2012) |
| Entity Number: | 000-298-867 |
| Register Number: | 000298867 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | 103 CONTINENTAL PLACE STE 200BRENTWOOD, TN 37027 |
| Registered Office Street Address: | 2 NORTH JACKSON STREET STE 605MONTGOMERY, AL 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073851630 | 2013-01-16 | 2023-05-01 | 330 SEVEN SPRINGS WAY, BRENTWOOD, TN, 370275098, US | 203 AVALON AVE, MUSCLE SHOALS, AL, 356612869, US | |||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 615-920-7000 |
| Fax | 6159208775 |
| Phone | +1 256-718-4041 |
Authorized person
| Name | MONICA BOWMAN |
| Role | PRESIDENT |
| Phone | 6159207000 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207V00000X - Obstetrics & Gynecology Physician |
| Is Primary | No |
| Taxonomy Code | 208200000X - Plastic Surgery Physician |
| Is Primary | No |
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 147841 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
