| Name: | CAPANO DIALYSIS, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 20 Sep 2016 (8 years ago) (Companies founded in September 2016) |
| Entity Number: | 000-372-199 |
| Register Number: | 000372199 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | 2000 16TH STREETDENVER, CO 80202 |
| Principal Mailing Address: | 601 HAWAII STREETEL SEGUNDO, CA 90245 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194234179 | 2017-09-22 | 2023-08-22 | 5200 VIRGINIA WAY, L&C DEPT, BRENTWOOD, TN, 370277569, US | 6521 HIGHWAY 69 S STE O, TUSCALOOSA, AL, 354056497, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 615-320-4268 |
| Fax | 8772380567 |
| Phone | +1 205-752-3267 |
| Fax | 2057523590 |
Authorized person
| Name | SAMUEL T WEY |
| Role | SR DIRECTOR LICENSURE&CERTIFICATION |
| Phone | 6153416641 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 226764 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
