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HARRIS LAKE EMERGENCY PHYSICIANS, LLC

Details

Name: HARRIS LAKE EMERGENCY PHYSICIANS, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 09 Mar 2017 (8 years ago) (Companies founded in March 2017)
Entity Number: 000-385-664
Register Number: 000385664
ZIP code: 36104 (Companies in Montgomery, 36104)
County: Montgomery
Place of Formation: Montgomery County
Registered Office Street Address: 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1255872594 2017-03-20 2023-03-22 13737 NOEL RD, 1600, DALLAS, TX, 752401331, US 1032 SOUTH MAIN STREET, WEDOWEE, AL, 36278, US

Contacts

Phone +1 954-838-2371
Phone +1 469-401-2386

Authorized person

Name KAREN VAUGHN
Role OFFICER
Phone 9732511132

Taxonomy

Taxonomy Code 207P00000X - Emergency Medicine Physician
Is Primary Yes

Agent

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