| Name: | Goode Medicine, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 21 Oct 2008 (16 years ago) (Companies founded in October 2008) |
| Date of dissolution: | 15 Aug 2013 |
| Entity Number: | 000-426-404 |
| Register Number: | 000426404 |
| ZIP code: | 36467 (Companies in Covington, 36467) |
| County: | Covington |
| Place of Formation: | Covington County |
| Principal Address: | OPP, AL |
| Registered Office Street Address: | 101 EAST PAULK AVE STE BOPP, AL 36467 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811134323 | 2009-01-21 | 2009-01-21 | 101 E PAULK AVE, SUITE B, OPP, AL, 364671727, US | 101 E PAULK AVE, SUITE B, OPP, AL, 364671727, US | |||||||||||||||||||||||||
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| Phone | +1 334-493-0233 |
| Fax | 3344930274 |
Authorized person
| Name | DR. STACY C GOODE |
| Role | OWNER |
| Phone | 3344930233 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 27479 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009913532 |
| State | AL |
| Name | Role |
|---|---|
| GOODE, STACY | Agent |
| Name | Role |
|---|---|
| GOODE, STACY | Member |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
