| 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) |
| Entity Number: | 000-404-028 |
| Register Number: | 000404028 |
| County: | Choctaw |
| Place of Formation: | Delaware |
| Principal Address: | 3506 BROAD STREETLISMAN, AL 36912 |
| Principal Address ZIP Code: | 36912 |
| Principal Mailing Address: | 1105 Southview Ln, 103-140TUSCALOOSA, AL 35405 |
| Principal Mailing Address ZIP Code: | 35405 |
| Registered Office Street Address: | 3506 BROAD STLISMAN, AL 36912 |
| Registered Office Street Address ZIP Code: | 36912 |
| 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 | |||||||||||||||
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| 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 |
| Name | Role |
|---|---|
| KNIGHTON, SHARON S | Agent |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
