| Name: | MED 360 URGENT CARE, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 13 Sep 2016 (8 years ago) (Companies founded in September 2016) |
| Entity Number: | 000-371-643 |
| Register Number: | 000371643 |
| ZIP code: | 35594 (Companies in Marion, 35594) |
| County: | Marion |
| Place of Formation: | Marion County |
| Registered Office Street Address: | 125 BOB LAWRENCE ROAD SUITE CWINFIELD, AL 35594 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871044677 | 2016-10-18 | 2024-03-13 | 1700 HIGHWAY 78 E, JASPER, AL, 355014036, US | 1700 HIGHWAY 78 E, JASPER, AL, 355014036, US | |||||||||||||||||||||||||
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| Phone | +1 205-412-5720 |
| Fax | 2054878827 |
| Phone | +1 205-512-1058 |
Authorized person
| Name | MR. FAROUK ANWARUL RAQUIB |
| Role | OWNER/PHYSICIAN |
| Phone | 2054874535 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| License Number | 170018 |
| State | AL |
| Is Primary | No |
| Name | Role |
|---|---|
| RAQUIB, FAROUK | Agent |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
