| Name: | R. Charles Goodman, Jr., OD, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 10 Dec 2014 (10 years ago) |
| Entity Number: | 000-324-006 |
| Register Number: | 000324006 |
| County: | Lee |
| Place of Formation: | Lee County |
| Principal Address: | 1829 JACOBS LANEAUBURN, AL 36830 |
| Principal Address ZIP Code: | 36830 |
Activities
CREATE/GROW/MAINTAIN WEALTH THROUGH ANY/ALL LEGAL MEANS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609266030 | 2015-01-23 | 2015-01-23 | 1110 EASTDALE MALL, MONTGOMERY, AL, 361172144, US | 1110 EASTDALE MALL, MONTGOMERY, AL, 361172144, US | |||||||||||||||||||||||||
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| Phone | +1 334-272-4722 |
| Fax | 3342725096 |
Authorized person
| Name | DR. ROY C GOODMAN JR. |
| Role | MEMBER |
| Phone | 3347503831 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | S729-TA155 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 143416 |
| State | AL |
| Name | Role |
|---|---|
| GOODMAN, ROY C JR | Agent |
| Name | Role | Address |
|---|---|---|
| GOODMAN, ROY CHARLES JR | Organizer | 1829 JACOBS LANEAUBURN, AL 36830 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
