| Name: | Alteon Health Alabama, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 10 Nov 2008 (16 years ago) |
| Entity Number: | 000-427-101 |
| Register Number: | 000427101 |
| Historical Names: |
Pegasus Emergency Group Troy Alabama, LLC
Pegasus Emergency Group SHA, LLC Island Medical Troy Alabama, LLC |
| County: | Montgomery |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
Activities
MEDICAL SERVICES TO MEDICAL FACILITES/EMERGENCY ROOM STAFFING
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477708857 | 2008-11-26 | 2023-02-24 | 4535 DRESSLER RD NW, CANTON, OH, 447182545, US | 604 STONE AVENUE, TALLADEGA, AL, 35160, US | |||||||||||||||||||
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| Phone | +1 330-994-4409 |
| Fax | 3304928489 |
| Phone | +1 844-474-4019 |
Authorized person
| Name | MELISSA REESE |
| Role | PROVIDER ENROLLMENT OFFICER |
| Phone | 8556870618 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
| Name | Role | Address |
|---|---|---|
| JUSTIN, ELLIOT | Member | 1007 E MAIN ST STE 300BOZEMAN, MT 59715 |
| SCHAMBAN, NEIL | Member | 1007 EAST MAIN STREET SUITE 300BOZEMAN, MT 59715 |
| ASHAR, TOM | Member | 121 DEVON DRIVEHOMEWOOD, AL 35209 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2021-06-11 | Name Merged | No data | Island Medical Shoals, LLC |
| 2021-06-11 | Name Merged | No data | Island Medical Red Bay, LLC |
| 2021-06-11 | Name Merged | No data | Island Medical Athens, LLC |
| 2021-06-11 | Name Merged | No data | Island Medical Coosa Valley, LLC |
| 2021-06-11 | Name Change | Island Medical Troy Alabama, LLC | Alteon Health Alabama, LLC |
| 2015-09-22 | Name Change | Pegasus Emergency Group SHA, LLC | Island Medical Troy Alabama, LLC |
| 2010-05-12 | Name Change | Pegasus Emergency Group Troy Alabama, LLC | Pegasus Emergency Group SHA, LLC |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
