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ATHENS LIMESTONE PEDIATRIC CENTER LLC

Details

Name: ATHENS LIMESTONE PEDIATRIC CENTER LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 30 Jun 2015 (9 years ago)
Entity Number: 000-339-403
Register Number: 000339403
County: Limestone
Place of Formation: Limestone County
Registered Office Street Address: 700 W MARKET STATHENS, AL 35611
Registered Office Street Address ZIP Code: 35611

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1972985968 2015-06-25 2015-06-25 700 W MARKET ST, ATHENS, AL, 356112457, US 101 FITNESS WAY STE 2100, ATHENS, AL, 356112494, US

Contacts

Phone +1 256-216-9730
Fax 2562169731

Authorized person

Name SEBRINA HOLT
Role COMPLIANCE DIRECTOR
Phone 2562169648

Taxonomy

Taxonomy Code 261QR1300X - Rural Health Clinic/Center
Is Primary Yes

Organizer

Name Role
COMER, JAMES R Organizer

Agent

Name Role
COMER, JAMES R Agent

Date of last update: 03 Aug 2024

Sources: Alabama Secretary of State