| Name: | OccuMed Health & Wellness, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 01 Aug 2017 (7 years ago) |
| Entity Number: | 000-398-372 |
| Register Number: | 000398372 |
| County: | Montgomery |
| Place of Formation: | Elmore County |
| Registered Office Mailing Address: | P.O. BOX 8021MONTGOMERY, AL 36110-0021 |
| Registered Office Street Address: | 2261 CONGRESSMAN W.L. DICKINSON DRMONTGOMERY, AL 36109 |
| Registered Office Street Address ZIP Code: | 36109 |
Activities
TP PROVIDE OCCUPATIONAL HEALTHCARE SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1972012771 | 2017-09-25 | 2018-06-16 | PO BOX 8021, MONTGOMERY, AL, 361100021, US | 1231 PERRY HILL RD STE C, MONTGOMERY, AL, 361095206, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 334-239-4957 |
| Fax | 3345931702 |
Authorized person
| Name | MRS. CYNTHIA RENEE BARRETT |
| Role | OWNER / CRNP |
| Phone | 3342394957 |
Taxonomy
| Taxonomy Code | 2083P0500X - Preventive Medicine/Occupational Environmental Medicine Physician |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 261QX0100X - Occupational Medicine Clinic/Center |
| License Number | 1-117172 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| License Number | 5742 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 363LX0106X - Occupational Health Nurse Practitioner |
| License Number | 1-117172 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | INDIVIDUAL NPI NUMBER |
| Number | 1720537335 |
| State | AL |
| Issuer | NRCME |
| Number | 5025477818 |
| Issuer | INDIVIDUAL NPI NUMBER |
| Number | 1598722753 |
| State | AL |
| Issuer | ANCC-CRNP |
| Number | 1-117172 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| BARRETT, CYNTHIA | Agent | 520 AVENUE VBIRMINGHAM, AL 35214 |
| Name | Role |
|---|---|
| ATCHESON, JENNIFER C | Member |
| Name | Role | Address |
|---|---|---|
| BARRETT, KIRK E | Organizer | 545 HOSPITAL DRIVEWETUMPKA, AL 36092 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
