| Name: | MedCenter Fayette, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 09 Feb 2016 (9 years ago) |
| Entity Number: | 000-354-564 |
| Register Number: | 000354564 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Registered Office Street Address: | 3909 MCFARLAND BOULEVARDTUSCALOOSA, AL 35476 |
| Registered Office Street Address ZIP Code: | 35476 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235590001 | 2016-03-08 | 2024-03-22 | 3909 MCFARLAND BLVD, NORTHPORT, AL, 354762838, US | 122 17TH CT NE, FAYETTE, AL, 355551353, US | |||||||||||||||||||||||||||||
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| Phone | +1 205-330-1707 |
| Fax | 2053330782 |
Authorized person
| Name | HOLLY POSEY JAMES |
| Role | EXECUTIVE DIRECTOR |
| Phone | 2053301707 |
Taxonomy
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| License Number | 12135 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MD LICENSE |
| Number | 12135 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| POSEY, ROBERT A | Agent | 1 RIDGELANDTUSCALOOSA, AL 35406 |
| Name | Role | Address |
|---|---|---|
| POSEY, ROBERT A | Organizer | 1 RIDGELANDTUSCALOOSA, AL 35406 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
