Search icon

MedCenter Fayette, LLC

Details

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

National Provider Identifier

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

Contacts

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

Agent

Name Role Address
POSEY, ROBERT A Agent 1 RIDGELANDTUSCALOOSA, AL 35406

Organizer

Name Role Address
POSEY, ROBERT A Organizer 1 RIDGELANDTUSCALOOSA, AL 35406

Date of last update: 03 Aug 2024

Sources: Alabama Secretary of State