| Name: | Huntsville Inpatient Services, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 14 Jan 2016 (9 years ago) (Companies founded in January 2016) |
| Date of dissolution: | 28 Feb 2024 |
| Entity Number: | 000-357-560 |
| Register Number: | 000357560 |
| ZIP code: | 35802 (Companies in Madison, 35802) |
| County: | Madison |
| Place of Formation: | Madison County |
| Registered Office Street Address: | 5005 LITTLEBURY ROAD SEHUNTSVILLE, AL 35802 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619338811 | 2016-03-15 | 2016-03-15 | 5005 LITTLEBURY RD SE, HUNTSVILLE, AL, 358021826, US | 101 SIVLEY RD SW, HUNTSVILLE, AL, 358014421, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 256-651-5374 |
Authorized person
| Name | WILLIAM R HUMPHREY |
| Role | PRESIDENT/OWNER |
| Phone | 2566515374 |
Taxonomy
| Taxonomy Code | 207RC0200X - Critical Care Medicine (Internal Medicine) Physician |
| License Number | 12374 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| License Number | 12374 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | PENDING |
| State | AL |
| Name | Role |
|---|---|
| HUMPHREY, W ROBERT JR | Organizer |
| Name | Role |
|---|---|
| HUMPHREY, W ROBERT JR | Agent |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
