| Name: | FMG PRIMECARE, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 14 Jun 2017 (7 years ago) |
| Entity Number: | 000-394-341 |
| Register Number: | 000394341 |
| ZIP code: | 36104 |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | 4000 MERIDIAN BLVDFRANKLIN, TN 37067 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427578228 | 2017-06-22 | 2022-06-27 | PO BOX 689022, FRANKLIN, TN, 370689022, US | 4126 W MAIN ST, DOTHAN, AL, 363059310, US | |||||||||||||||||||
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| Phone | +1 615-465-7230 |
| Phone | +1 334-793-2120 |
Authorized person
| Name | JENNY L JACKSON |
| Role | SR DIR PROV ENROLLMENT & ONBOARDING |
| Phone | 8778929815 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| 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
