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LAVACA PRIMARY HEALTH SYSTEMS, L.L.C.

Details

Name: LAVACA PRIMARY HEALTH SYSTEMS, L.L.C.
Jurisdiction: Alabama
Legal type: Foreign Limited Liability Company
Status: Exists
Date of registration: 19 Sep 2017 (7 years ago) (Companies founded in September 2017)
Entity Number: 000-404-028
Register Number: 000404028
ZIP code: 36912 (Companies in Choctaw, 36912)
County: Choctaw
Place of Formation: Delaware
Principal Address: 3506 BROAD STREETLISMAN, AL 36912
Principal Mailing Address: 1105 Southview Ln, 103-140TUSCALOOSA, AL 35405
Registered Office Street Address: 3506 BROAD STLISMAN, AL 36912

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1235617333 2018-07-31 2018-07-31 1105 SOUTHVIEW LN # 103-140, TUSCALOOSA, AL, 354056390, US 3915 PALISADES DR STE C, TUSCALOOSA, AL, 354053415, US

Contacts

Phone +1 470-235-9354
Phone +1 205-248-2073

Authorized person

Name REGINAL N VINES
Role OWNER
Phone 4702359354

Taxonomy

Taxonomy Code 332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary Yes

Agent

Name Role
KNIGHTON, SHARON S Agent

Date of last update: 13 Aug 2024

Sources: Alabama Secretary of State