| Name: | MOON LAKE EMERGENCY PHYSICIANS, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 13 Oct 2015 (9 years ago) (Companies founded in October 2015) |
| Entity Number: | 000-345-331 |
| Register Number: | 000345331 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831561455 | 2015-10-22 | 2019-09-10 | 13737 NOEL RD, STE 1600, DALLAS, TX, 752401331, US | 4401 RIVER CHASE DR, PHENIX CITY, AL, 368677483, US | |||||||||||||||
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| Phone | +1 954-838-2371 |
| Phone | +1 469-401-2386 |
Authorized person
| Name | KATHLEEN KONDAS |
| Role | OFFICER |
| Phone | 9548382371 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
| Name | Role |
|---|---|
| WILSON, CRAIG A | Organizer |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
